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Bernabei I, Faure E, Romani M, Wegrzyn J, Brinckmann J, Chobaz V, So A, Hugle T, Busso N, Nasi S. Inhibiting Lysyl Oxidases prevents pathologic cartilage calcification. Biomed Pharmacother 2024; 171:116075. [PMID: 38183742 DOI: 10.1016/j.biopha.2023.116075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/08/2024] Open
Abstract
Lysyl oxidases (LOX(L)) are enzymes that catalyze the formation of cross-links in collagen and elastin fibers during physiologic calcification of bone. However, it remains unknown whether they may promote pathologic calcification of articular cartilage, an important hallmark of debilitating arthropathies. Here, we have studied the possible roles of LOX(L) in cartilage calcification, related and not related to their cross-linking activity. We first demonstrated that inhibition of LOX(L) by β-aminoproprionitrile (BAPN) significantly reduced calcification in murine and human chondrocytes, and in joint of meniscectomized mice. These BAPN's effects on calcification were accounted for by different LOX(L) roles. Firstly, reduced LOX(L)-mediated extracellular matrix cross-links downregulated Anx5, Pit1 and Pit2 calcification genes. Secondly, BAPN reduced collagen fibrotic markers Col1 and Col3. Additionally, LOX(L) inhibition blocked chondrocytes hypertrophic differentiation (Runx2 and COL10), pro-inflammatory IL-6 release and reactive oxygen species (ROS) production, all triggers of chondrocyte calcification. Through unbiased transcriptomic analysis we confirmed a positive correlation between LOX(L) genes and genes for calcification, hypertrophy and extracellular matrix catabolism. This association was conserved throughout species (mouse, human) and tissues that can undergo pathologic calcification (kidney, arteries, skin). Overall, LOX(L) play a critical role in the process of chondrocyte calcification and may be therapeutic targets to treat cartilage calcification in arthropathies.
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Affiliation(s)
- Ilaria Bernabei
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne; Lausanne, Switzerland
| | - Elodie Faure
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne; Lausanne, Switzerland
| | - Mario Romani
- Aging and Bone Metabolism Laboratory, Service of Geriatric Medicine & Geriatric Rehabilitation, Department of Medicine, Lausanne University Hospital and University of Lausanne; Lausanne, Switzerland
| | - Julien Wegrzyn
- Department of Orthopedic Surgery, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Jürgen Brinckmann
- Department of Dermatology and Institute of Virology and Cell Biology, University of Lübeck, Lübeck, Germany
| | - Véronique Chobaz
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne; Lausanne, Switzerland
| | - Alexander So
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne; Lausanne, Switzerland
| | - Thomas Hugle
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne; Lausanne, Switzerland
| | - Nathalie Busso
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne; Lausanne, Switzerland
| | - Sonia Nasi
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne; Lausanne, Switzerland.
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Abhishek A, Tedeschi SK, Pascart T, Latourte A, Dalbeth N, Neogi T, Fuller A, Rosenthal A, Becce F, Bardin T, Ea HK, Filippou G, FitzGerald J, Iagnocco A, Lioté F, McCarthy GM, Ramonda R, Richette P, Sivera F, Andres M, Cipolletta E, Doherty M, Pascual E, Perez-Ruiz F, So A, Jansen TL, Kohler MJ, Stamp LK, Yinh J, Adinolfi A, Arad U, Aung T, Benillouche E, Bortoluzzi A, Dau J, Maningding E, Fang MA, Figus FA, Filippucci E, Haslett J, Janssen M, Kaldas M, Kimoto M, Leamy K, Navarro GM, Sarzi-Puttini P, Scirè C, Silvagni E, Sirotti S, Stack JR, Truong L, Xie C, Yokose C, Hendry AM, Terkeltaub R, Taylor WJ, Choi HK. The 2023 ACR/EULAR Classification Criteria for Calcium Pyrophosphate Deposition Disease. Arthritis Rheumatol 2023; 75:1703-1713. [PMID: 37494275 PMCID: PMC10543651 DOI: 10.1002/art.42619] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/19/2023] [Accepted: 05/23/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE Calcium pyrophosphate deposition (CPPD) disease is prevalent and has diverse presentations, but there are no validated classification criteria for this symptomatic arthritis. The American College of Rheumatology (ACR) and EULAR have developed the first-ever validated classification criteria for symptomatic CPPD disease. METHODS Supported by the ACR and EULAR, a multinational group of investigators followed established methodology to develop these disease classification criteria. The group generated lists of candidate items and refined their definitions, collected de-identified patient profiles, evaluated strengths of associations between candidate items and CPPD disease, developed a classification criteria framework, and used multi-criterion decision analysis to define criteria weights and a classification threshold score. The criteria were validated in an independent cohort. RESULTS Among patients with joint pain, swelling, or tenderness (entry criterion) whose symptoms are not fully explained by an alternative disease (exclusion criterion), the presence of crowned dens syndrome or calcium pyrophosphate crystals in synovial fluid are sufficient to classify a patient as having CPPD disease. In the absence of these findings, a score >56 points using weighted criteria, comprising clinical features, associated metabolic disorders, and results of laboratory and imaging investigations, can be used to classify as CPPD disease. These criteria had a sensitivity of 92.2% and specificity of 87.9% in the derivation cohort (190 CPPD cases, 148 mimickers), whereas sensitivity was 99.2% and specificity was 92.5% in the validation cohort (251 CPPD cases, 162 mimickers). CONCLUSION The 2023 ACR/EULAR CPPD disease classification criteria have excellent performance characteristics and will facilitate research in this field.
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Affiliation(s)
| | - Sara K Tedeschi
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Tristan Pascart
- Department of Rheumatology, Lille Catholic University, Saint-Philibert Hospital, Lille, France
| | - Augustin Latourte
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Tuhina Neogi
- Department of Medicine, Section of Rheumatology, Boston University School of Medicine, Boston, Massachusetts
| | - Amy Fuller
- Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Ann Rosenthal
- Department of Medicine, Medical College of Wisconsin, Milwaukee
| | - Fabio Becce
- Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Thomas Bardin
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Hang Korng Ea
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Georgios Filippou
- Rheumatology Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - John FitzGerald
- David Geffen School of Medicine, University of California, and Veterans Administration for Greater Los Angeles, Los Angeles, California
| | - AnnaMaria Iagnocco
- Academic Rheumatology Center, Università degli Studi di Torino, Turin, Italy
| | - Frédéric Lioté
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, Service de Rhumatologie, AP-HP, Lariboisière Hospital, and Université Paris Cité, Faculté de Santé, Paris, France
| | - Geraldine M McCarthy
- School of Medicine and Medical Science, University College Dublin, and Mater Misericordiae University Hospital, Dublin, Ireland
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Pascal Richette
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Francisca Sivera
- Department of Rheumatology, Hospital General Universitario Elda, Elda, Spain, and Department of Clinical Medicine, Universidad Miguel Hernandez, Elche, Spain
| | - Mariano Andres
- Department of Medicine, Rheumatology Section, Hospital General Universitario de Alicante, Universidad Miguel Hernández, Alicante, Spain
| | - Edoardo Cipolletta
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Michael Doherty
- Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Eliseo Pascual
- Rheumatology Division, Cruces University Hospital, Bilbao, Spain
| | - Fernando Perez-Ruiz
- Arthritis Investigation Group, Biocruces-Bizkaia Health Research Institute, Spain, Department of Medicine, Medicine and Nursing School, University of the Basque Country, and Basque Country Rheumatology Society, Bilbao, Spain
| | - Alexander So
- Lausanne University Hospital, Lausanne, Switzerland
| | - Tim L Jansen
- VieCuri Medical Centre, Venlo, The Netherlands, and Medical Cell BioPhysics Group, University of Twente, Enschede, The Netherlands
| | - Minna J Kohler
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Lisa K Stamp
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Janeth Yinh
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
| | | | - Uri Arad
- Department of Rheumatology, Te Whatu Ora-Health New Zealand Waikato, Hamilton, New Zealand
| | - Thanda Aung
- Division of Rheumatology, University of California, Los Angeles
| | - Eva Benillouche
- Department of Rheumatology, Lausanne University Hospital, Lausanne, Switzerland
| | - Alessandra Bortoluzzi
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy, and Azienda Ospedaliera-Universitaria di Ferrara, Cona (FE), Italy
| | - Jonathan Dau
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, Boston
| | | | - Meika A Fang
- David Geffen School of Medicine, University of California, and Veterans Administration for Greater Los Angeles, Los Angeles, California
| | - Fabiana A Figus
- Rheumatology Division, Local Health Unit (ASL), Turin-3, Collegno and Pinerolo, Italy
| | - Emilio Filippucci
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Janine Haslett
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | | | - Marian Kaldas
- David Geffen School of Medicine, University of California, Los Angeles
| | - Maryann Kimoto
- David Geffen School of Medicine, University of California, Los Angeles
| | - Kelly Leamy
- Mater Misericordiae University Hospital, Dublin, Ireland
| | | | | | - Carlo Scirè
- Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy
| | - Ettore Silvagni
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy, and Azienda Ospedaliera-Universitaria di Ferrara, Cona (FE), Italy
| | - Silvia Sirotti
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - John R Stack
- School of Medicine and Medical Science, University College Dublin, and Mater Misericordiae University Hospital, Dublin, Ireland
| | - Linh Truong
- Division of Rheumatology, University of California, Los Angeles, California
| | - Chen Xie
- Division of Rheumatology, University of California, Los Angeles, California
| | - Chio Yokose
- Harvard Medical School, Boston, Massachusetts
| | - Alison M Hendry
- Department of Medicine, General Medicine and Rheumatology, Middlemore Hospital, Counties Manukau Health District, New Zealand
| | - Robert Terkeltaub
- San Diego Veterans Administration Healthcare Service, and University of California, San Diego
| | - William J Taylor
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
| | - Hyon K Choi
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts
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3
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Abhishek A, Tedeschi SK, Pascart T, Latourte A, Dalbeth N, Neogi T, Fuller A, Rosenthal A, Becce F, Bardin T, Ea HK, Filippou G, Fitzgerald J, Iagnocco A, Lioté F, McCarthy GM, Ramonda R, Richette P, Sivera F, Andrés M, Cipolletta E, Doherty M, Pascual E, Perez-Ruiz F, So A, Jansen TL, Kohler MJ, Stamp LK, Yinh J, Adinolfi A, Arad U, Aung T, Benillouche E, Bortoluzzi A, Dau J, Maningding E, Fang MA, Figus FA, Filippucci E, Haslett J, Janssen M, Kaldas M, Kimoto M, Leamy K, Navarro GM, Sarzi-Puttini P, Scirè C, Silvagni E, Sirotti S, Stack JR, Truong L, Xie C, Yokose C, Hendry AM, Terkeltaub R, Taylor WJ, Choi HK. The 2023 ACR/EULAR classification criteria for calcium pyrophosphate deposition disease. Ann Rheum Dis 2023; 82:1248-1257. [PMID: 37495237 PMCID: PMC10529191 DOI: 10.1136/ard-2023-224575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 06/14/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE Calcium pyrophosphate deposition (CPPD) disease is prevalent and has diverse presentations, but there are no validated classification criteria for this symptomatic arthritis. The American College of Rheumatology (ACR) and EULAR have developed the first-ever validated classification criteria for symptomatic CPPD disease. METHODS Supported by the ACR and EULAR, a multinational group of investigators followed established methodology to develop these disease classification criteria. The group generated lists of candidate items and refined their definitions, collected de-identified patient profiles, evaluated strengths of associations between candidate items and CPPD disease, developed a classification criteria framework, and used multi-criterion decision analysis to define criteria weights and a classification threshold score. The criteria were validated in an independent cohort. RESULTS Among patients with joint pain, swelling, or tenderness (entry criterion) whose symptoms are not fully explained by an alternative disease (exclusion criterion), the presence of crowned dens syndrome or calcium pyrophosphate crystals in synovial fluid are sufficient to classify a patient as having CPPD disease. In the absence of these findings, a score>56 points using weighted criteria, comprising clinical features, associated metabolic disorders, and results of laboratory and imaging investigations, can be used to classify as CPPD disease. These criteria had a sensitivity of 92.2% and specificity of 87.9% in the derivation cohort (190 CPPD cases, 148 mimickers), whereas sensitivity was 99.2% and specificity was 92.5% in the validation cohort (251 CPPD cases, 162 mimickers). CONCLUSION The 2023 ACR/EULAR CPPD disease classification criteria have excellent performance characteristics and will facilitate research in this field.
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Affiliation(s)
| | - Sara K Tedeschi
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Tristan Pascart
- Department of Rheumatology, Lille Catholic University, Saint-Philibert Hospital, Lille, France
| | - Augustin Latourte
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Tuhina Neogi
- Department of Medicine, Section of Rheumatology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Amy Fuller
- Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Ann Rosenthal
- Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Fabio Becce
- Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Thomas Bardin
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Hang-Korng Ea
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Georgios Filippou
- Rheumatology Department, IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - John Fitzgerald
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
- Veterans Administration for Greater Los Angeles, Los Angeles, California, USA
| | - AnnaMaria Iagnocco
- Academic Rheumatology Center, Università degli Studi di Torino, Turin, Italy
| | - Frédéric Lioté
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
- Université Paris Cité, Faculté de Santé, Paris, France
| | - Geraldine M McCarthy
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Pascal Richette
- Université de Paris, INSERM, UMR-S 1132 BIOSCAR, and Service de Rhumatologie, AP-HP, Lariboisière Hospital, Paris, France
| | - Francisca Sivera
- Department of Rheumatology, Hospital General Universitario Elda, Elda, Spain
- Department of Clinical Medicine, Universidad Miguel Hernandez, Elche, Spain
| | - Mariano Andrés
- Department of Medicine, Rheumatology Section, Hospital General Universitario de Alicante, Universidad Miguel Hernández, Alicante, Spain
| | - Edoardo Cipolletta
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Michael Doherty
- Academic Rheumatology, University of Nottingham, Nottingham, UK
| | - Eliseo Pascual
- Rheumatology Division, Cruces University Hospital, Bilbao, Spain
| | - Fernando Perez-Ruiz
- Arthritis Investigation Group, Biocruces-Bizkaia Health Research Institute, Spain, Department of Medicine, Medicine and Nursing School, University of the Basque Country, and Basque Country Rheumatology Society, Bilbao, Spain
| | - Alexander So
- Lausanne University Hospital, Lausanne, Switzerland
| | - Tim L Jansen
- VieCuri Medical Centre, Venlo, The Netherlands
- Medical Cell BioPhysics Group, University of Twente, Enschede, The Netherlands
| | - Minna J Kohler
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Lisa K Stamp
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Janeth Yinh
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | | | - Uri Arad
- Department of Rheumatology, Te Whatu Ora-Health New Zealand Waikato, Hamilton, New Zealand
| | - Thanda Aung
- Division of Rheumatology, University of California, Los Angeles, California, USA
| | - Eva Benillouche
- Department of Rheumatology, Lausanne University Hospital, Lausanne, Switzerland
| | - Alessandra Bortoluzzi
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
- Azienda Ospedaliera-Universitaria di Ferrara (Cona FE), Cona FE, Italy
| | - Jonathan Dau
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Meika A Fang
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
- Veterans Administration for Greater Los Angeles, Los Angeles, California, USA
| | - Fabiana A Figus
- Rheumatology Division, Local Health Unit (ASL), Turin-3, Collegno and Pinerolo, Italy
| | - Emilio Filippucci
- Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Janine Haslett
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | | | - Marian Kaldas
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Maryann Kimoto
- David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Kelly Leamy
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - Geraldine M Navarro
- Division of Rheumatology, University of California, Los Angeles, California, USA
| | | | - Carlo Scirè
- Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy
| | - Ettore Silvagni
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
- Azienda Ospedaliera-Universitaria di Ferrara (Cona FE), Cona FE, Italy
| | - Silvia Sirotti
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - John R Stack
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - Linh Truong
- Division of Rheumatology, University of California, Los Angeles, California, USA
| | - Chen Xie
- Division of Rheumatology, University of California, Los Angeles, California, USA
| | - Chio Yokose
- Harvard Medical School, Boston, Massachusetts, USA
| | - Alison M Hendry
- Department of Medicine, General Medicine and Rheumatology, Middlemore Hospital, Counties Manukau Health District, Auckland, New Zealand
| | - Robert Terkeltaub
- San Diego Veterans Administration Healthcare Service, and University of California, San Diego, California, USA
| | - William J Taylor
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Hyon K Choi
- Department of Medicine, Rheumatology Unit, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, USA
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Heidenreich A, Ladi Seyedian S, Alsyouf M, Hu B, Cary C, Masterson T, Einhorn L, Adra N, Boorjian S, Schuckman A, Bagrodia A, Kollmannsberger C, So A, Black P, Skinner E, Alemozaffar M, Brand T, Eggener S, Pierorazio P, Pierorazio K, Nappi L, Nichols C, Daneshmand S. Surgical and oncologic outcomes of surgery in early metastatic seminoma: Multi-institutional retrospective study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00795-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Abstract
Pathological calcification of cartilage is a hallmark of osteoarthritis (OA). Calcification can be observed both at the cartilage surface and in its deeper layers. The formation of calcium-containing crystals, typically basic calcium phosphate (BCP) and calcium pyrophosphate dihydrate (CPP) crystals, is an active, highly regulated and complex biological process that is initiated by chondrocytes and modified by genetic factors, dysregulated mitophagy or apoptosis, inflammation and the activation of specific cellular-signalling pathways. The links between OA and BCP deposition are stronger than those observed between OA and CPP deposition. Here, we review the molecular processes involved in cartilage calcification in OA and summarize the effects of calcium crystals on chondrocytes, synovial fibroblasts, macrophages and bone cells. Finally, we highlight therapeutic pathways leading to decreased joint calcification and potential new drugs that could treat not only OA but also other diseases associated with pathological calcification.
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Affiliation(s)
- Ilaria Bernabei
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Alexander So
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
| | - Nathalie Busso
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Sonia Nasi
- Service of Rheumatology, Department of Musculoskeletal Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
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Sumpter NA, Takei R, Cadzow M, Topless RKG, Phipps-Green AJ, Murphy R, de Zoysa J, Watson H, Qasim M, Lupi AS, Abhishek A, Andrés M, Crișan TO, Doherty M, Jacobsson L, Janssen M, Jansen TL, Joosten LAB, Kapetanovic M, Lioté F, Matsuo H, McCarthy GM, Perez-Ruiz F, Riches P, Richette P, Roddy E, Stiburkova B, So A, Tausche AK, Torres RJ, Uhlig T, Major TJ, Stamp LK, Dalbeth N, Choi HK, Vazquez AI, Leask MP, Reynolds RJ, Merriman TR. Association of Gout Polygenic Risk Score With Age at Disease Onset and Tophaceous Disease in European and Polynesian Men With Gout. Arthritis Rheumatol 2022; 75:816-825. [PMID: 36281732 DOI: 10.1002/art.42393] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 09/19/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine whether a gout polygenic risk score (PRS) is associated with age at gout onset and tophaceous disease in European, East Polynesian, and West Polynesian men and women with gout. METHODS A 19-variant gout PRS was produced in 7 European gout cohorts (N = 4,016), 2 East Polynesian gout cohorts (N = 682), and 1 West Polynesian gout cohort (N = 490). Sex-stratified regression models were used to estimate the relationship between the PRS and age at gout onset and tophaceous disease. RESULTS The PRS was associated with earlier age at gout onset in men (β = -3.61 in years per unit PRS [95% confidence interval (95% CI) -4.32, -2.90] in European men; β = -6.35 [95% CI -8.91, -3.80] in East Polynesian men; β = -3.51 [95% CI -5.46, -1.57] in West Polynesian men) but not in women (β = 0.07 [95% CI -2.32, 2.45] in European women; β = 0.20 [95% CI -7.21, 7.62] in East Polynesian women; β -3.33 [95% CI -9.28, 2.62] in West Polynesian women). The PRS showed a positive association with tophaceous disease in men (odds ratio [OR] for the association 1.15 [95% CI 1.00, 1.31] in European men; OR 2.60 [95% CI 1.66, 4.06] in East Polynesian men; OR 1.53 [95% CI 1.07, 2.19] in West Polynesian men) but not in women (OR for the association 0.68 [95% CI 0.42, 1.10] in European women; OR 1.45 [95% CI 0.39, 5.36] in East Polynesian women). The PRS association with age at gout onset was robust to the removal of ABCG2 variants from the PRS in European and East Polynesian men (β = -2.42 [95% CI -3.37, -1.46] and β = -6.80 [95% CI -10.06, -3.55], respectively) but not in West Polynesian men (β = -1.79 [95% CI -4.74, 1.16]). CONCLUSION Genetic risk variants for gout also harbor risk for earlier age at gout onset and tophaceous disease in European and Polynesian men. Our findings suggest that earlier gout onset involves the accumulation of gout risk alleles in men but perhaps not in women, and that this genetic risk is shared across multiple ancestral groups.
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Affiliation(s)
- Nicholas A Sumpter
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, and Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Riku Takei
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham
| | - Murray Cadzow
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Ruth K G Topless
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | | | - Rinki Murphy
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Janak de Zoysa
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Huti Watson
- Ngāti Porou Hauora Trust, Te Puia Springs, New Zealand
| | | | - Alexa S Lupi
- Department of Epidemiology and Biostatistics, Michigan State University, and The Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, Michigan
| | - Abhishek Abhishek
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, UK, and GlobalGoutGenetics Consortium
| | - Mariano Andrés
- GlobalGoutGenetics Consortium, and Department of Rheumatology, Alicante General University Hospital-ISABIAL, Miguel Hernandez University, Alicante, Spain
| | - Tania O Crișan
- GlobalGoutGenetics Consortium, and Department of Medical Genetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Michael Doherty
- Academic Rheumatology, School of Medicine, University of Nottingham, Nottingham City Hospital, Nottingham, UK, and GlobalGoutGenetics Consortium
| | - Lennart Jacobsson
- GlobalGoutGenetics Consortium, and Department of Rheumatology & Inflammation Research, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Matthijs Janssen
- GlobalGoutGenetics Consortium, and Complex Gout Expert Centre, Department of Rheumatology, Viecuri Medical Centre, Venlo, The Netherlands
| | - Tim L Jansen
- GlobalGoutGenetics Consortium, and Complex Gout Expert Centre, Department of Rheumatology, Viecuri Medical Centre, Venlo, The Netherlands
| | - Leo A B Joosten
- GlobalGoutGenetics Consortium, and Department of Medical Genetics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania, and Department of Internal Medicine, Radboud Institute of Molecular Life Sciences (RIMLS), Radboud University Medical Center, Nijmegen, The Netherlands
| | - Meliha Kapetanovic
- GlobalGoutGenetics Consortium, and Lund University and Skåne University Hospital, Lund, Sweden
| | - Frédéric Lioté
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Hirotaka Matsuo
- GlobalGoutGenetics Consortium, and Department of Integrative Physiology and Bio-Nano Medicine, National Defense Medical College, Saitama, Japan
| | - Geraldine M McCarthy
- GlobalGoutGenetics Consortium, and Mater Misericordiae University Hospital and University College, Dublin, Ireland
| | - Fernando Perez-Ruiz
- GlobalGoutGenetics Consortium, and Rheumatology Division, Osakidetza, OSI EE-Cruces, Cruces University Hospital, Barakaldo, Biocruces-Bizkaia Health Research Institute, Barakaldo, and the Medicine Department of the Medicine School of the University of the Basque Country, Leioa, Spain
| | - Philip Riches
- GlobalGoutGenetics Consortium, and IGC, University of Edinburgh, Scotland
| | - Pascal Richette
- GlobalGoutGenetics Consortium, and Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université Paris Cité, Paris, France
| | - Edward Roddy
- GlobalGoutGenetics Consortium, and School of Medicine, Keele University, Keele, Staffordshire, UK
| | - Blanka Stiburkova
- GlobalGoutGenetics Consortium, and Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic, and Institute of Rheumatology, Prague, Czech Republic
| | - Alexander So
- GlobalGoutGenetics Consortium, and Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Anne-Kathrin Tausche
- GlobalGoutGenetics Consortium, and Division of Rheumatology, University Clinic Carl Gustav Carus at the TU Dresden, Dresden, Germany
| | - Rosa J Torres
- GlobalGoutGenetics Consortium, and Department of Biochemistry, La Paz University Hospital Health Research Institute (FIBHULP), IdiPaz, and Center for Biomedical Network Research on Rare Diseases (CIBERER), ISCIII, Madrid, Spain
| | - Till Uhlig
- GlobalGoutGenetics Consortium, and Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
| | - Tanya J Major
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Lisa K Stamp
- GlobalGoutGenetics Consortium, and Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Nicola Dalbeth
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand, and GlobalGoutGenetics Consortium
| | - Hyon K Choi
- Clinical Epidemiology Unit, Massachusetts General Hospital, Boston
| | - Ana I Vazquez
- Department of Epidemiology and Biostatistics, Michigan State University, and The Institute for Quantitative Health Science & Engineering, Michigan State University, East Lansing, Michigan
| | - Megan P Leask
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham
| | - Richard J Reynolds
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham
| | - Tony R Merriman
- Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Department of Biochemistry, University of Otago, Dunedin, New Zealand, and GlobalGoutGenetics Consortium
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Tedeschi SK, Pascart T, Latourte A, Godsave C, Kundakci B, Naden RP, Taylor WJ, Dalbeth N, Neogi T, Perez-Ruiz F, Rosenthal A, Becce F, Pascual E, Andres M, Bardin T, Doherty M, Ea HK, Filippou G, FitzGerald J, Guitierrez M, Iagnocco A, Jansen TL, Kohler MJ, Lioté F, Matza M, McCarthy GM, Ramonda R, Reginato AM, Richette P, Singh JA, Sivera F, So A, Stamp LK, Yinh J, Yokose C, Terkeltaub R, Choi H, Abhishek A. Identifying Potential Classification Criteria for Calcium Pyrophosphate Deposition Disease: Item Generation and Item Reduction. Arthritis Care Res (Hoboken) 2022; 74:1649-1658. [PMID: 33973414 PMCID: PMC8578594 DOI: 10.1002/acr.24619] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/24/2021] [Accepted: 04/06/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Classification criteria for calcium pyrophosphate deposition (CPPD) disease will facilitate clinical research on this common crystalline arthritis. Our objective was to report on the first 2 phases of a 4-phase process for developing CPPD classification criteria. METHODS CPPD classification criteria development is overseen by a 12-member steering committee. Item generation (phase I) included a scoping literature review of 5 literature databases and contributions from a 35-member combined expert committee and 2 patient research partners. Item reduction and refinement (phase II) involved a combined expert committee meeting, discussions among clinical, imaging, and laboratory advisory groups, and an item-rating exercise to assess the influence of individual items toward classification. The steering committee reviewed the modal rating score for each item (range -3 [strongly pushes away from CPPD] to +3 [strongly pushes toward CPPD]) to determine items to retain for future phases of criteria development. RESULTS Item generation yielded 420 items (312 from the literature, 108 from experts/patients). The advisory groups eliminated items that they agreed were unlikely to distinguish between CPPD and other forms of arthritis, yielding 127 items for the item-rating exercise. Fifty-six items, most of which had a modal rating of +/- 2 or 3, were retained for future phases. As numerous imaging items were rated +3, the steering committee recommended focusing on imaging of the knee and wrist and 1 additional affected joint for calcification suggestive of CPP crystal deposition. CONCLUSION A data- and expert-driven process is underway to develop CPPD classification criteria. Candidate items comprise clinical, imaging, and laboratory features.
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Affiliation(s)
- Sara K. Tedeschi
- Division of Rheumatology, Inflammation and Immunity,
Brigham and Women’s Hospital and Harvard Medical School, Boston, United
States
| | - Tristan Pascart
- Department of Rheumatology, Lille Catholic University,
Lille, France
| | - Augustin Latourte
- Department of Rheumatology, Centre Viggo Petersen,
Hôpital Lariboisière, Université de Paris, Paris, France
| | - Cattleya Godsave
- Department of Academic Rheumatology, University of
Nottingham, Nottingham, United Kingdom
| | - Burak Kundakci
- Department of Academic Rheumatology, University of
Nottingham, Nottingham, United Kingdom
| | - Raymond P. Naden
- Department of Medicine, Auckland City Hospital, Auckland,
New Zealand
| | | | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland,
New Zealand
| | - Tuhina Neogi
- Section of Rheumatology, Boston University School of
Medicine, Boston, MA, United States
| | - Fernando Perez-Ruiz
- Osakidetza, OSI EE-Cruces, Cruces University Hospital,
Biocruces-Bizkaia Health Research Institute and University of the Basque Country,
Basque Country, Spain
| | - Ann Rosenthal
- Department of Rheumatology, Medical College of
Wisconsin, Milwaukee, United States
| | - Fabio Becce
- Department of Radiology, Lausanne University Hospital,
Lausanne, Switzerland
| | - Eliseo Pascual
- Department of Rheumatology, Hospital General
Universitario de Alicante, Alicante Institute of Sanitary and Biomedical Research,
Alicante, Spain
| | - Mariano Andres
- Department of Rheumatology, Hospital General
Universitario de Alicante, Alicante Institute of Sanitary and Biomedical Research,
Alicante, Spain
| | - Thomas Bardin
- Department of Rheumatology, Centre Viggo Petersen,
Hôpital Lariboisière, Université de Paris, Paris, France
| | - Michael Doherty
- Department of Academic Rheumatology, University of
Nottingham, Nottingham, United Kingdom
| | - Hang-Korng Ea
- Department of Rheumatology, Centre Viggo Petersen,
Hôpital Lariboisière, Université de Paris, Paris, France
| | - Georgios Filippou
- Division of Rheumatology, Luigi Sacco University
Hospital, Milan, Italy
| | - John FitzGerald
- Greater Los Angeles VA Healthcare Service and Division
of Rheumatology, David Geffen School of Medicine, University of California-Los
Angeles, Los Angeles, United States
| | - Marwin Guitierrez
- Division of Musculoskeletal and Rheumatic Disorders,
Instituto Nacional de Rehabilitacion, Mexico City, Mexico
| | - Annamaria Iagnocco
- Academic Rheumatology Centre, Dipartimento Scienze
Cliniche e Biologiche, Università degli Studi di Torino, Turin, Italy
| | - Tim L. Jansen
- Department of Rheumatology, VieCuri Medical Center,
Venlo, Noord-Limburg, and University of Twente, Faculty Science & Technology,
Enschede, Netherlands
| | - Minna J. Kohler
- Division of Rheumatology, Allergy, and Immunology,
Massachusetts General Hospital and Harvard Medical School, Boston, United
States
| | - Frédéric Lioté
- Department of Rheumatology, Centre Viggo Petersen,
Hôpital Lariboisière, Université de Paris, Paris, France
| | - Mark Matza
- Division of Rheumatology, Allergy, and Immunology,
Massachusetts General Hospital and Harvard Medical School, Boston, United
States
| | | | - Roberta Ramonda
- Rheumatology Unit, Department of Medicine-DIMED,
University of Padova, Padova, Italy
| | | | - Pascal Richette
- Department of Rheumatology, Centre Viggo Petersen,
Hôpital Lariboisière, Université de Paris, Paris, France
| | - Jasvinder A. Singh
- Division of Rheumatology, University of Alabama at
Birmingham, and Birmingham Veterans Affairs Medical Center, Birmingham, United
States
| | - Francisca Sivera
- Department of Rheumatology, Hospital General
Universitario Elda, Elda, Spain, and Departamento de Medicina, Universidad Miguel
Hernandez, Elche, Spain
| | - Alexander So
- Department of Musculoskeletal Medicine, University
Hospital of Lausanne, Lausanne, Switzerland
| | - Lisa K. Stamp
- Division of Medicine, University of Otago, Christchurch,
New Zealand
| | - Janeth Yinh
- Division of Rheumatology, Allergy, and Immunology,
Massachusetts General Hospital and Harvard Medical School, Boston, United
States
| | - Chio Yokose
- Division of Rheumatology, Allergy, and Immunology,
Massachusetts General Hospital and Harvard Medical School, Boston, United
States
| | - Robert Terkeltaub
- San Diego VA Healthcare Service, Division of
Rheumatology, Allergy and Immunology, University of California-San Diego, San Diego,
United States
| | - Hyon Choi
- Division of Rheumatology, Allergy, and Immunology,
Massachusetts General Hospital and Harvard Medical School, Boston, United
States
| | - Abhishek Abhishek
- Department of Academic Rheumatology, University of
Nottingham, Nottingham, United Kingdom
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Hügle T, Nasi S, Ehirchiou D, Omoumi P, So A, Busso N. Fibrin deposition associates with cartilage degeneration in arthritis. EBioMedicine 2022; 81:104081. [PMID: 35660787 PMCID: PMC9163430 DOI: 10.1016/j.ebiom.2022.104081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/11/2022] [Accepted: 05/11/2022] [Indexed: 12/04/2022] Open
Abstract
Background Cartilage damage in inflammatory arthritis is attributed to inflammatory cytokines and pannus infiltration. Activation of the coagulation system is a well known feature of arthritis, especially in rheumatoid arthritis (RA). Here we describe mechanisms by which fibrin directly mediates cartilage degeneration. Methods Fibrin deposits were stained on cartilage and synovial tissue of RA and osteoarthritis (OA) patients and in murine adjuvant-induced arthritis (AIA) in wild-type or fibrinogen deficient mice. Fibrinogen expression and procoagulant activity in chondrocytes were evaluated using qRT-PCR analysis and turbidimetry. Chondro-synovial adhesion was studied in co-cultures of human RA cartilage and synoviocytes, and in the AIA model. Calcific deposits were stained in human RA and OA cartilage and in vitro in fibrinogen-stimulated chondrocytes. Findings Fibrin deposits on cartilage correlated with the severity of cartilage damage in human RA explants and in AIA in wild-type mice, whilst fibrinogen deficient mice were protected. Fibrin upregulated Adamts5 and Mmp13 in chondrocytes. Chondro-synovial adhesion only occurred in fibrin-rich cartilage areas and correlated with cartilage damage. In vitro, autologous human synoviocytes, cultured on RA cartilage explants, adhered exclusively to fibrin-rich areas. Fibrin co-localized with calcification in human RA cartilage and triggered chondrocyte mineralization by inducing pro-calcification genes (Anx5, Pit1, Pc1) and the IL-6 cytokine. Similar fibrin-mediated mechanisms were observed in OA models, but to a lesser extent and without pseudo-membranes formation. Interpretation In arthritis, fibrin plaques directly impair cartilage integrity via a triad of catabolism, adhesion, and calcification. Funding None.
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Schwotzer N, Auberson M, Livio F, So A, Bonny O. [Management of hyperuricemia in chronic kidney disease]. Rev Med Suisse 2022; 18:379-384. [PMID: 35235261 DOI: 10.53738/revmed.2022.18.771.379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Hyperuricemia is often encountered as glomerular filtration rate decreased. It is associated with a more rapid decline of the renal function, but causality has not been demonstrated. Recent studies showed that treatment of hyperuricemia did not affect the progression in chronic kidney disease (CKD) patients. Thus, treatment with hypouricemic drugs of patients suffering of CKD and displaying asymptomatic hyperuricemia is not recommended. However, patients with CKD present often with acute flairs of gout, which might be difficult to treat. Therapeutic options are discussed in this article.
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Affiliation(s)
- Nora Schwotzer
- Service de néphrologie et d'hypertension, Département de médecine, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Muriel Auberson
- Département des sciences biomédicales, Université de Lausanne, 1015 Lausanne
| | - Françoise Livio
- Service de pharmacologie clinique, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Alexander So
- Service de rhumatologie, Département de l'appareil locomoteur, Centre hospitalier universitaire vaudois, 1011 Lausanne
| | - Olivier Bonny
- Service de néphrologie et d'hypertension, Département de médecine, Centre hospitalier universitaire vaudois, 1011 Lausanne
- Département des sciences biomédicales, Université de Lausanne, 1015 Lausanne
- Service de néphrologie, Clinique de médecine, Hôpital fribourgeois, 1708 Fribourg
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Chau O, Islam A, Yu E, Qu M, Butler J, Biernaski H, Sun A, Bissonnette JP, MacDonald A, Graf C, So A, Wisenberg G, Lee T, Prato FS, Gaede S. Multi-Modality Imaging Assessment of the Heart Before and After Stage III Non-Small Cell Lung Cancer Radiotherapy. Adv Radiat Oncol 2022; 7:100927. [PMID: 35434423 PMCID: PMC9006649 DOI: 10.1016/j.adro.2022.100927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 02/07/2022] [Indexed: 11/26/2022] Open
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Hügle T, Nasi S, Ehirchiou D, Omoumi P, So A, Busso N. POS0393 FIBRIN DEPOSITION IS AN ACTIVE TRIGGER OF CARTILAGE DEGENERATION IN RHEUMATOID ARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Fibrin(ogen) maintains inflammation in various disorders but has never been linked to cartilage damage in rheumatoid arthritis (RA) or other forms of inflammatory arthritis.Objectives:To investigate the role of fibrin deposition on cartilage integrity in arthritis.Methods:Fibrin deposition on knee cartilage was analyzed by immunohistochemistry in RA patients and in murine adjuvant-induced arthritis (AIA). In chondrocytes, fibrinogen expression (Fgα, Fgβ, Fgγ) and procoagulant activity were evaluated by qRT-PCR and turbidimetry respectively. Fibrin-induced catabolic genes were assessed by qRT-PCR in chondrocytes. Fibrin-mediated chondro-synovial adhesion (CSA) with subsequent cartilage tears was studied in co-cultures of human RA cartilage with autologous synoviocytes, in the AIA model, and by MRI. The link between fibrin and calcification was examined in human RA cartilage stained for calcific deposits and in vitro in fibrinogen-stimulated chondrocytes.Results:Fibrin deposition on cartilage correlated with the severity of cartilage damage in human RA explants and in AIA wildtype (WT) mice, while fibrinogen deficient (Fg-/-) mice were protected. Accordingly, fibrin upregulated catabolic enzymes (Adamts5 and Mmp13) in chondrocytes. Secondly, CSA was present in fibrin-rich and damaged cartilage in AIA WT but not in Fg-/- mice. In line, autologous human synoviocytes, cultured on RA cartilage explants, adhered exclusively to fibrin-positive degraded areas. Gadolinium-enhanced MRI of human joints showed contrast-enhancement along cartilage surface in RA patients but not in controls. Finally, fibrin co-localized with calcification in human RA cartilage and triggered chondrocyte mineralization inducing pro-calcification genes (Anx5, Pit1, Pc1) and cytokine (IL-6). Although at a much lesser extent, we observed similar fibrin-mediated mechanisms in osteoarthritis (OA).Conclusion:Fibrin deposition directly impacts on cartilage integrity via induction of catabolism, mechanical stress, and calcification. Potentially, fibrin is a key factor of cartilage damage occurring in RA as a secondary consequence of inflammation.Disclosure of Interests:None declared
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Zorn K, Bidair M, Bhojani N, Trainer A, Arther A, Kramolowsky E, Doumanian L, Elterman D, Kaufman R, Lingeman J, Krambeck A, Eure G, Badlani G, Plante M, Gin G, Goldenberg L, Patterson R, So A, Humphreys M, Kaplan S, Motola J, Desai M, Roehrborn C. Aquablation for benign prostatic hyperplasia in large prostates (80-150cc): 3-year results. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00452-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Bernabei I, Kronenberg D, Stange R, Bertrand J, Hügle T, So A, Busso N, Nasi S. POS0041 THE GASOTRANSMITTER HYDROGEN SULFIDE (H2S) IS PROTECTIVE AGAINST CALCIFIC TENDINOPATHY (CT). Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Pathological (or heterotopic) calcification is the deposition of calcium-containing crystals in soft tissues that normally do not calcify. The deposition of these crystals in tendons such as the rotator cuff and the Achilles tendon is known as calcific tendinopathy (CT). CT is a painful condition, which increases tendon rupture rate and leads to disability.Objectives:To understand what inhibits calcification, in order to provide new strategies to treat a condition for which existing therapies are ineffective.Methods:We investigated the role of the gasotransmitter hydrogen sulfide (H2S), and in particular of the H2S-producing enzyme cystathionine γ-lyase (CSE) in CT. In vitro, we induced calcification in tenocytes from WT and CSE KO mice or we treated WT tenocytes with different H2S donors. In vivo, calcification was assessed in a surgery-induced murine model of CT (tenotomy of the Achilles tendon) and in a spontaneous model of CT (aging). Samples obtained from patients with rotator cuff or Achilles tendon CT were also analyzed. To investigate the underlying mechanisms of the CSE-H2S effect, we focused on the bone morphogenic proteins (BMPs) pathway. We additionally explored if altered extracellular matrix (ECM) organization, due to lysyl oxidase (LOX) activity and aberrant collagen-crosslinks, could also be involved in CT. In this context, we studied if H2S could affect LOX expression and activity.Results:In vitro, tenocyte calcification was inhibited by exogenous H2S-donors, while it was exacerbated in CSE KO tenocytes. The protective role of CSE-H2S was confirmed in vivo. In aged mice, microtomography analysis revealed exacerbated Achilles tendon calcification in CSE KO mice compared to WT. In the surgery-induced model of CT, an inverse correlation between calcification and CSE expression in operated Achilles tendon was seen over time. Similarly, inversed correlation between calcification and CSE expression was found in human CT samples.Reduced calcification in tenocytes exposed to H2S was accompanied by decreased expression of genes coding for BMP2, BMP4 and decreased activation of the BMP signaling pathway (pSMAD1/5/8). On the contrary, BMPs expression and BMPs-pathway activation were exacerbated in CSE KO tenocytes compared to WT tenocytes.We next investigated whether ECM disorganization could play a role in CT. Tenocytes cultured in calcification media and treated with the pan-inhibitor of lysyl oxidases (LOX, LOXL1-4) β-aminopropionitrile (BAPN) showed decreased calcification. This pointed to a potential beneficial role of LOX inhibition, therefore decreased collagen-crosslinks, in CT. By analysis of LOXs gene expression in WT and CSE KO tenocytes cultured in calcifying condition, we found much higher expression (4-fold) of LOX, LOL2 and LOXL4 in CSE KO tenocytes. Moreover, H2S-donors inhibited LOX activity. Altogether, these results suggest that decreased H2S could lead to aberrant LOX expression and activity, excessive collagen cross-links in the ECM, and ultimately calcification. Further experiments are ongoing to prove these hypotheses.Conclusion:We suggest targeting H2S production by CSE, or supplying an H2S-donor, is of therapeutic relevance to pathological calcification in the context of CT and can modify its disease course.The anti-mineralizing effect of H2S in tendons could be due to both inhibition of the BMPs pathway and suppression of abnormal LOXs activity.Disclosure of Interests:None declared.
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Tedeschi S, Pascart T, Latourte A, Godsave C, Kundaki B, Naden R, Taylor W, Dalbeth N, Neogi T, Perez-Ruiz F, Rosenthal A, Becce F, Pascual E, Andrés M, Bardin T, Doherty M, Ea HK, Filippou G, Fitzgerald J, Gutierrez M, Iagnocco A, Jansen T, Kohler M, Lioté F, Matza M, Mccarthy G, Ramonda R, Reginato A, Richette P, Singh J, Sivera F, So A, Stamp L, Yinh J, Yokose C, Terkeltaub R, Choi H, Abhishek A. POS1124 IDENTIFYING POTENTIAL CLASSIFICATION CRITERIA FOR CALCIUM PYROPHOSPHATE DEPOSITION DISEASE (CPPD): RESULTS FROM THE INITIAL PHASES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Classification criteria for calcium pyrophosphate deposition disease (CPPD) will facilitate clinical research on this common crystalline arthritis. ACR/EULAR are jointly sponsoring development of CPPD classification criteria using a multi-phase process.Objectives:To report preliminary results from the first two phases of a four-phase process for developing CPPD classification criteria.Methods:CPPD classification criteria development is overseen by a 12-member Steering Committee. Item generation (Phase I) included a scoping literature review of five literature databases and contributions from a 35-member Combined Expert Committee and two Patient Research Partners. Item reduction and refinement (Phase II) involved a Combined Expert Committee meeting, discussions among Clinical, Imaging, and Laboratory Advisory Groups, and an item rating exercise to assess the influence of individual items toward classification. The Steering Committee reviewed the modal rating score for each item (range -3 [strongly pushes away from CPPD] to +3 [strongly pushes toward CPPD]) to determine items to retain for future phases of criteria development.Results:Item generation yielded 420 items (312 from the literature, 108 from experts/patients). The Advisory Groups eliminated items they agreed were unlikely to distinguish between CPPD and other forms of arthritis, yielding 127 items for the item rating exercise. Fifty-six items, most of which had a modal rating of +/- 2 or 3, were retained for future phases (see Table 1). As numerous imaging items were rated +3, the Steering Committee recommended focusing on imaging of the knee, wrist, and one additional affected joint for calcification suggestive of CPP crystal deposition.Conclusion:The ACR/EULAR CPPD classification criteria working group has adopted both data- and expert-driven approaches, leading to 56 candidate items broadly categorized as clinical, imaging, and laboratory features. Remaining steps for criteria development include domain establishment, item weighting through a multi-criteria decision analysis exercise, threshold score determination, and criteria validation.Table 1.Categories of items retained for future phases of classification criteria developmentAge in decade at symptom onsetAcute inflammatory arthritis (e.g. knee, wrist, 1st MTP joint*)Recurrence and pattern of joint involvement (e.g. 1 self-limited episode, >1 self-limited episode)Physical findings (e.g. palpable subcutaneous tophus*, psoriasis*)Co-morbidities and family history (e.g. Gitelman disease, hemochromatosis, familial CPPD)Osteoarthritis location and features (e.g. 2nd or 3rd MCP joint, wrist)Synovial fluid findings (e.g. CPP crystals present, CPP crystals absent on 1 occasion* or 2 occasions*, monosodium urate crystals present*)Laboratory findings (e.g. hypomagnesemia, hyperparathyroidism, rheumatoid factor*, anti-CCP*)Plain radiograph: calcification in regions of fibro- or hyaline cartilage+Plain radiograph: calcification of the synovial membrane/capsule/tendon+Conventional CT: calcification in regions of fibro- or hyaline cartilage+Conventional CT: calcification of the synovial membrane/capsule/tendon+Ultrasound: CPP crystal deposition in fibro- or hyaline cartilage+Ultrasound: CPP crystal deposition in synovial membrane/capsule/tendons+Dual-energy CT: CPP crystal deposition in fibro- or hyaline cartilage+Dual-energy CT: CPP crystal deposition in synovial membrane/capsule/tendon+*Potential negative predictor +Assessed in the knee, wrist, and/or 1 additional affected jointDisclosure of Interests:Sara Tedeschi Consultant of: NGM Biopharmaceuticals, Tristan Pascart: None declared, Augustin Latourte Consultant of: Novartis, Cattleya Godsave: None declared, Burak Kundaki: None declared, Raymond Naden: None declared, William Taylor: None declared, Nicola Dalbeth Speakers bureau: Abbvie and Janssen, Consultant of: AstraZeneca, Dyve, Selecta, Horizon, Arthrosi, and Cello Health, Tuhina Neogi: None declared, Fernando Perez-Ruiz: None declared, Ann Rosenthal: None declared, Fabio Becce Consultant of: Horizon Therapeutics, Grant/research support from: Siemens Healthineers, Eliseo Pascual: None declared, Mariano Andrés: None declared, Thomas Bardin: None declared, Michael Doherty: None declared, Hang Korng Ea: None declared, Georgios Filippou: None declared, John FitzGerald: None declared, Marwin Gutierrez: None declared, Annamaria Iagnocco: None declared, Tim Jansen Speakers bureau: Abbvie, Amgen, BMS, Grunenthal, Olatec, Sanofi Genzyme, Consultant of: Abbvie, Amgen, BMS, Grunenthal, Olatec, Sanofi Genzyme, Minna Kohler Speakers bureau: Lilly, Consultant of: Novartis, Frederic Lioté: None declared, Mark Matza: None declared, Geraldine McCarthy Consultant of: PK Med, Roberta Ramonda: None declared, Anthony Reginato: None declared, Pascal Richette: None declared, Jasvinder Singh Speakers bureau: Simply Speaking, Consultant of: Crealta/Horizon, Medisys, Fidia, UBM LLC, Trio health, Medscape, WebMD, Adept Field Solutions, Clinical Care options, Clearview healthcare partners, Putnam associates, Focus forward, Navigant consulting, Spherix, Practice Point communications, Francisca Sivera: None declared, Alexander So: None declared, Lisa Stamp: None declared, Janeth Yinh: None declared, Chio Yokose: None declared, Robert Terkeltaub Consultant of: Sobi, Horizon Therapeutics, Astra-Zeneca, Selecta, Grant/research support from: Astra-Zeneca, Hyon Choi: None declared, Abhishek Abhishek Consultant of: NGM Biopharmaceuticals.
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Dumusc A, So A. Answer to Cipolletta et al. "Treatment of acute CPP crystal arthritis: What are we missing?". Joint Bone Spine 2021;88:105217. Joint Bone Spine 2021; 88:105223. [PMID: 34029748 DOI: 10.1016/j.jbspin.2021.105223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Accepted: 04/30/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Alexandre Dumusc
- Department of Rheumatology, Lausanne University Hospital (CHUV), avenue Pierre-Decker 4, 1005 Lausanne, Switzerland.
| | - Alexander So
- Department of Rheumatology, Lausanne University Hospital (CHUV), avenue Pierre-Decker 4, 1005 Lausanne, Switzerland
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Di Capua J, Reid N, Som A, An T, Lopez D, So A, Di C, Walker T. Abstract No. 162 The effect of preprocedural renal failure on outcomes following infrainguinal endovascular arterial interventions. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Saag KG, Khanna PP, Keenan RT, Ohlman S, Osterling Koskinen L, Sparve E, Åkerblad AC, Wikén M, So A, Pillinger MH, Terkeltaub R. A Randomized, Phase II Study Evaluating the Efficacy and Safety of Anakinra in the Treatment of Gout Flares. Arthritis Rheumatol 2021; 73:1533-1542. [PMID: 33605029 DOI: 10.1002/art.41699] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 02/11/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of anakinra compared to triamcinolone in the treatment of gout flares. METHODS Patients for whom nonsteroidal antiinflammatory drugs and colchicine were not suitable treatments were enrolled in this multicenter, randomized, double-blind study with follow-up for up to 2 years. The study was designed to assess superiority of anakinra (100 or 200 mg/day for 5 days) over triamcinolone (40 mg in a single injection) for the primary end point of changed patient-assessed pain intensity in the most affected joint (scored on a visual analog scale of 0-100) from baseline to 24-72 hours. Secondary outcome measures included: safety, immunogenicity, and patient- and physician-assessed global response. RESULTS One hundred sixty-five patients were randomized to receive anakinra (n = 110) or triamcinolone (n = 55). The median age was 55 years (range 25-83), 87% were men, the mean disease duration was 8.7 years, and the mean number of self-reported flares during the prior year was 4.5. A total of 301 flares were treated (214 with anakinra; 87 with triamcinolone). Anakinra in both doses and triamcinolone provided clinically meaningful reduction in patient-assessed pain intensity in the first and subsequent flares. For the first flare, the mean decline in pain intensity from baseline to 24-72 hours for total anakinra and triamcinolone was -41.2 and -39.4, respectively (P = 0.688). Anakinra performed better than triamcinolone for most secondary end points. There were no unexpected safety findings. The presence of antidrug antibodies was not associated with adverse events or altered pain reduction. CONCLUSION Anakinra was not superior to triamcinolone for the primary end point, but had comparable efficacy in pain reduction and was favored for most secondary end points. Anakinra is an effective option for gout flares when conventional therapy is unsuitable.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Robert Terkeltaub
- San Diego VA Healthcare Service and University of California San Diego, La Jolla
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Nasi S, Castelblanco M, Chobaz V, Ehirchiou D, So A, Bernabei I, Kusano T, Nishino T, Okamoto K, Busso N. Xanthine Oxidoreductase Is Involved in Chondrocyte Mineralization and Expressed in Osteoarthritic Damaged Cartilage. Front Cell Dev Biol 2021; 9:612440. [PMID: 33634117 PMCID: PMC7900416 DOI: 10.3389/fcell.2021.612440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 01/15/2021] [Indexed: 12/19/2022] Open
Abstract
Pathologic calcification of cartilage consists of the formation of basic calcium phosphate (BCP) and/or calcium pyrophosphate dihydrate (CPPD) containing calcium crystals in mature hyaline or articular cartilage and is associated with aging, cartilage injury and likely plays a role in accelerating the pathology of osteoarthritis (OA). The pathways regulating joint calcification, in particular cartilage calcification, are not completely understood, but inflammation and the formation of reactive oxygen species (ROS) are contributory factors. The xanthine oxidase (XO) form of xanthine oxidoreductase (XOR), the key enzyme in xanthine and uric acid metabolism, is a major cellular source of superoxide. We hypothesized that XOR could be implicated in chondrocyte mineralization and cartilage calcification and degradation in OA. We showed both in murine primary chondrocyte and chondrogenic ATDC5 cells, that mineralization was inhibited by two different XOR inhibitors, febuxostat and allopurinol. In addition, XOR inhibition reduced the expression of the pro-mineralizing cytokine interleukin-6 (IL-6). We next generated XOR knock-out chondrocyte cell lines with undetectable XOR expression and XO activity. XOR knock-out chondrocyte cells showed decreased mineralization and reduced alkaline phosphatase (Alp) activity. To assess the precise form of XOR involved, primary chondrocytes of XOR mutant mice expressing either the XDH form (XDH ki) or the XO form (XO ki) were studied. We found that XO ki chondrocytes exhibited increased mineralization compared to XDH ki chondrocytes, and this was associated with enhanced Alp activity, ROS generation and IL-6 secretion. Finally, we found increased XOR expression in damaged vs. undamaged cartilage obtained from OA patients and XOR expression partially co-localized with areas showing pathologic calcification. Altogether, our results suggest that XOR, via its XO form, contribute to chondrocyte mineralization and pathological calcification in OA cartilage.
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Affiliation(s)
- Sonia Nasi
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Mariela Castelblanco
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Véronique Chobaz
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Driss Ehirchiou
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Alexander So
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Ilaria Bernabei
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Teruo Kusano
- Department of Biochemistry and Molecular Biology, Nippon Medical School, Tokyo, Japan
| | - Takeshi Nishino
- Department of Biochemistry and Molecular Biology, Nippon Medical School, Tokyo, Japan
| | - Ken Okamoto
- Department of Biochemistry and Molecular Biology, Nippon Medical School, Tokyo, Japan
| | - Nathalie Busso
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
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Zaidi F, Narang RK, Phipps-Green A, Gamble GG, Tausche AK, So A, Riches P, Andres M, Perez-Ruiz F, Doherty M, Janssen M, Joosten LAB, Jansen TL, Kurreeman F, Torres RJ, McCarthy GM, Miner JN, Stamp LK, Merriman TR, Dalbeth N. Systematic genetic analysis of early-onset gout: ABCG2 is the only associated locus. Rheumatology (Oxford) 2021; 59:2544-2549. [PMID: 31998961 DOI: 10.1093/rheumatology/kez685] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 12/12/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The aim of this study was to examine whether serum urate-associated genetic variants are associated with early-onset gout. METHODS Participants with gout in the Genetics of Gout in Aotearoa study with available genotyping were included (n = 1648). Early-onset gout was defined as the first presentation of gout <40 years of age. Single nucleotide polymorphisms (SNPs) for the 10 loci most strongly associated with serum urate were genotyped. Allelic association of the SNPs with early-onset gout was tested using logistic regression in an unadjusted model and in a model adjusted for sex, body mass index, tophus presence, flare frequency, serum creatinine and highest serum urate. The analysis was also done in two replication cohorts: Eurogout (n = 704) and Ardea (n = 755), and data were meta-analysed. RESULTS In the Genetics of Gout in Aotearoa study, there were 638 (42.4%) participants with early-onset gout. The ABCG2 rs2231142 gout risk T-allele was present more frequently in participants with early-onset gout compared with the later-onset group. For the other SNPs tested, no differences in risk allele number were observed. In the allelic association analysis, the ABCG2 rs2231142 T-allele was associated with early-onset gout in unadjusted and adjusted models. Analysis of the replication cohorts confirmed the association of early-onset gout with the ABCG2 rs2231142 T-allele, but not with other serum urate-associated SNPs. In the meta-analysis, the odds ratio (95% CI) for early-onset gout for the ABCG2 rs2231142 T-allele was 1.60 (1.41, 1.83). CONCLUSION In contrast to other serum urate-raising variants, the ABCG2 rs2231142 T-allele is strongly associated with early-onset gout.
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Affiliation(s)
- Faseeh Zaidi
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, AucklandNew Zealand
| | - Ravi K Narang
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, AucklandNew Zealand
| | | | - Greg G Gamble
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, AucklandNew Zealand
| | | | - Alexander So
- Department of Medicine, Service of Rheumatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Philip Riches
- Rheumatology and Bone Disease Unit, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Mariano Andres
- Department of Medicine, Sección de Reumatología, Hospital General Universitario de Alicante, Alicante, Spain
| | - Fernando Perez-Ruiz
- Rheumatology Division, Hospital Universitario Cruces, Baracaldo, Biscay, Spain
| | - Michael Doherty
- Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Matthijs Janssen
- Department of Rheumatology, VieCuri Medical Center, Venlo, The Netherlands
| | - Leo A B Joosten
- Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Medical Genetics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Tim L Jansen
- Department of Rheumatology, VieCuri Medical Center, Venlo, The Netherlands
| | - Fina Kurreeman
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Rosa J Torres
- Department of Biochemistry, La Paz University Hospital Health Research Institute (FIBHULP), IdiPaz, Madrid, Spain.,Center for Biomedical Network Research on Rare Diseases (CIBERER), ISCIII, Madrid, Spain
| | - Geraldine M McCarthy
- Department of Rheumatology, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | | | - Lisa K Stamp
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Tony R Merriman
- Department of Biochemistry, University of Otago, Dunedin, New Zealand
| | - Nicola Dalbeth
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, AucklandNew Zealand
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Ehirchiou D, Bernabei I, Chobaz V, Castelblanco M, Hügle T, So A, Zhang L, Busso N, Nasi S. CD11b Signaling Prevents Chondrocyte Mineralization and Attenuates the Severity of Osteoarthritis. Front Cell Dev Biol 2020; 8:611757. [PMID: 33392201 PMCID: PMC7775404 DOI: 10.3389/fcell.2020.611757] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/02/2020] [Indexed: 11/13/2022] Open
Abstract
Osteoarthritis (OA) is a progressive joint disease that is strongly associated with calcium-containing crystal formation (mineralization) by chondrocytes leading ultimately to cartilage calcification. However, this calcification process is poorly understood and treatments targeting the underlying disease mechanisms are lacking. The CD11b/CD18 integrin (Mac-1 or αMβ2), a member of the beta 2 integrin family of adhesion receptors, is critically involved in the development of several inflammatory diseases, including rheumatoid arthritis and systemic lupus erythematosus. We found that in a collagen-induced arthritis, CD11b-deficient mice exhibited increased cartilage degradation compared to WT control animals. However, the functional significance of CD11b integrin signaling in the pathophysiology of chondrocytes remains unknown. CD11b expression was found in the extracellular matrix and in chondrocytes in both healthy and damaged human and murine articular cartilage. Primary murine CD11b KO chondrocytes showed increased mineralization when induced in vitro by secondary calciprotein particles (CPP) and quantified by Alizarin Red staining. This increased propensity to mineralize was associated with an increased alkaline phosphatase (Alp) expression (measured by qRT-PCR and activity assay) and an enhanced secretion of the pro-mineralizing IL-6 cytokine compared to control wild-type cells (measured by ELISA). Accordingly, addition of an anti-IL-6 receptor antibody to CD11b KO chondrocytes reduced significantly the calcification and identified IL-6 as a pro-mineralizing factor in these cells. In the same conditions, the ratio of qRT-PCR expression of collagen X over collagen II, and that of Runx2 over Sox9 (both ratio being indexes of chondrocyte hypertrophy) were increased in CD11b-deficient cells. Conversely, the CD11b activator LA1 reduced chondrocyte mineralization, Alp expression, IL-6 production and collagen X expression. In the meniscectomy (MNX) model of murine knee osteoarthritis, deficiency of CD11b led to more severe OA (OARSI scoring of medial cartilage damage in CD11b: 5.6 ± 1.8, in WT: 1.2 ± 0.5, p < 0.05, inflammation in CD11b: 2.8 ± 0.2, in WT: 1.4 ± 0.5). In conclusion, these data demonstrate that CD11b signaling prevents chondrocyte hypertrophy and chondrocyte mineralization in vitro and has a protective role in models of OA in vivo.
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Affiliation(s)
- Driss Ehirchiou
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Ilaria Bernabei
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Véronique Chobaz
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Mariela Castelblanco
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Thomas Hügle
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Alexander So
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Li Zhang
- Department of Physiology, Center for Vascular and Inflammatory Diseases, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Nathalie Busso
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Sonia Nasi
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
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Dumusc A, Pazar Maldonado B, Benaim C, Zufferey P, Aubry-Rozier B, So A. Anakinra compared to prednisone in the treatment of acute CPPD crystal arthritis: A randomized controlled double-blinded pilot study. Joint Bone Spine 2020; 88:105088. [PMID: 33445133 DOI: 10.1016/j.jbspin.2020.105088] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/05/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Alexandre Dumusc
- Rheumatology Department, Lausanne University Hospital, avenue Pierre-Decker 4, 1005 Lausanne, Switzerland.
| | - Borbala Pazar Maldonado
- Rheumatology Department, Lausanne University Hospital, avenue Pierre-Decker 4, 1005 Lausanne, Switzerland
| | - Charles Benaim
- Physical Medicine and Rehabilitation Department, Lausanne University Hospital, 1005 Lausanne, Switzerland
| | - Pascal Zufferey
- Rheumatology Department, Lausanne University Hospital, avenue Pierre-Decker 4, 1005 Lausanne, Switzerland
| | - Bérengère Aubry-Rozier
- Rheumatology Department, Lausanne University Hospital, avenue Pierre-Decker 4, 1005 Lausanne, Switzerland
| | - Alexander So
- Rheumatology Department, Lausanne University Hospital, avenue Pierre-Decker 4, 1005 Lausanne, Switzerland
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Khan H, Deif B, So A, Lee T, Tang A. APPROACH TO THE LEFT SIDED PURKINJE SYSTEM AND LEFT VENTRICLE ENDOCARDIUM DIRECTLY FROM THE RIGHT ATRIUM - POTENTIAL NEW APPROACH TO LBBAP. Can J Cardiol 2020. [DOI: 10.1016/j.cjca.2020.07.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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So A. Current understanding of gout and optimal management strategies. Semin Arthritis Rheum 2020; 50:812. [PMID: 32559683 DOI: 10.1016/j.semarthrit.2020.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Alexander So
- Service of Rheumatology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
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Saag K, Khanna P, Keenan R, Ohlman S, Sparve E, Lindqvist D, Åkerblad AC, Wikén M, So A, Pillinger MH, Terkeltaub R. THU0439 EFFICACY AND SAFETY OF ANAKINRA IN THE TREATMENT OF RECURRENT GOUT FLARES: RESULTS FROM THE EXTENSION PHASE OF THE ANAGO STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The anaGO (anakinra ingout) study was a multi-center, randomized, double-blind, double-dummy, phase 2 study investigating the efficacy and safety of anakinra for recurrent gout flares. Results from subsequent flares (extension phase) are presented in relation to the previously reported results from the 1stflare (flare at study enrollment).Objectives:The objective of the extension phase was to evaluate the efficacy, safety and immunogenicity of two anakinra regimens (100 or 200 mg daily s.c. injections for 5 days) compared to triamcinolone (single i.m. injection 40 mg) for subsequent flares after initial study enrollment flare. The primary endpoint of the study was change in patient-assessed flare pain intensity from baseline to 24-72 hours (average of 24, 48 and 72 hours) in the most affected joint measured on a visual analogue scale (0-100 VAS). Secondary endpoints included: patient’s and physician’s assessments of global response, anti-drug antibodies (ADA) and safety.Methods:The study included patients with acute gout (ACR/EULAR 2015 gout classification criteria) unsuitable for anti-inflammatory therapy with NSAIDs and colchicine due to contraindication, intolerance or inefficacy. Patients were eligible for treatment of subsequent flares for up to 2 years. Each patient received the same treatment for all flares, starying with the flare at enrollment.Results:161 patients were treated for 1 flare, 61 patients for 2 flares, 31 patients for 3, and 20 patients for 4 or more flares with 1 patient treated for 9 flares. In total, 300 flares were treated in the full study; anakinra 100 mg and 200 mg, 107 and 106 flares, respectively; and triamcinolone, 87 flares. Both anakinra doses and triamcinolone provided a clinical meaningful reduction in patient-assessed pain intensity in both the 1stand subsequent flares. Mean changes in pain intensity from baseline to 24–72 hours for total anakinra and triamcinolone were: 1stflare -41.2 and -39.4; 2ndflare -33.9 and -31.1; 3rdflare -31.8 and -51.2, respectively. Mean differences in pain reduction between anakinra and triamcinolone treatment groups were (negative value favors anakinra): 1stflare -1.8, 2ndflare -2.8 3rdflare 19.4. The majority of secondary endpoints favored anakinra, including patient’s and physician’s global assessement of response and physician’s assessement of the joint. No unexpected safety findings during subsequent flares were identified. 21 patients (19.6%) developed ADA to anakinra in low titers at some time point; 7 (6.5%) had pre-existing ADA at baseline and 12 (11.2%) developed treatment induced ADA. 2 patients had pre-existing ADA to triamcinolone at baseline. 4 patients on anakinra (3.7%) developed neutralizing antibodies (NAbs). Pre-dose 72 hour anakinra serum concentrations were in similar range for ADA+ and ADA- patients. Presence of ADA was not associated with adverse events or had an impact on pain reduction.Conclusion:The efficacy and safety of anakinra and triamcinolone in subsequent flares were similar to the findings from 1stflare in patients with acute gout. Patient-assessed pain in the 1stand 2ndflare was reduced to similar degrees in all treatment groups, but to a larger extent in the 3rdflare in the small triamcinolone group. Secondary endpoints were in favor of anakinra across flares 1 to 3. The overall incidence of ADA and NAb was low also after repeated anakinra dosing and did not appear to impact exposure, efficacy or safety. In conclusion, anakinra was shown to be an option in the treatment of recurrent gout flares in patients for whom conventional therapy is unsuitable.Disclosure of Interests: :Kenneth Saag Grant/research support from: Horizon, Sobi, Shanton, Grant/research support from: Horizon Pharma, Sobi, Shanton, Consultant of: Horizon and Sobi, Consultant of: Horizon Pharma, Amgen, Radius, LG-Pharma, Takeda, Sobi, Atom, Arthrosi, Puja Khanna Grant/research support from: Dyve, Selecta, Sobi, Consultant of: Sobi, Horizon, Robert Keenan Consultant of: Sobi, Selecta, Horizon, Sven Ohlman Shareholder of: Sobi, Employee of: Former employee of Sobi, Erik Sparve Shareholder of: Sobi, Employee of: Sobi, Daniel Lindqvist Employee of: Sobi, Ann-Charlotte Åkerblad Shareholder of: Sobi, Employee of: Sobi, Margareta Wikén Shareholder of: Sobi, Employee of: Former employee of Sobi, Alexander So Consultant of: Sobi, Grünenthal, Michael H. Pillinger Grant/research support from: Horizon, Hikma, Consultant of: Sobi, Horizon, Robert Terkeltaub Consultant of: Sobi, Selecta, Horizon, Astra-Zeneca
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So A. Current understanding of gout and optimal management strategies. Semin Arthritis Rheum 2020; 50:S1. [DOI: 10.1016/j.semarthrit.2020.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Saag K, So A, Khanna P, Keenan R, Ohlman S, Kullenberg T, Osterling Koskinen L, Pillinger MH, Terkeltaub R. THU0409 A RANDOMIZED, PHASE 2 STUDY EVALUATING THE EFFICACY AND SAFETY OF ANAKINRA IN DIFFICULT-TO-TREAT ACUTE GOUTY ARTHRITIS: THE ANAGO STUDY. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3766] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:In gout, urate crystals deposited in and around joints trigger episodes of acute arthritis, mediated by the proinflammatory cytokine IL-1β. In uncontrolled studies, the IL-1 receptor antagonist anakinra appears effective in reducing pain and signs of acute flares in patients with difficult-to-treat gout. However, confirmatory, adequately-powered, prospective trials are lacking. The ‘anaGO-study’ (anakinra ingout) was a multi-center, randomized, double-blind, double-dummy, phase 2 study investigating the efficacy and safety of anakinra in acute gout (NCT03002974).Objectives:The primary objective was to evaluate the efficacy of two regimens of anakinra (100 or 200 mg daily s.c. injections for 5 days) compared to triamcinolone (single i.m. injection 40 mg) with respect to patient-assessed pain intensity. The primary endpoint was change in pain intensity from baseline to 24-72 hours (average of 24, 48 and 72 hours) in the most affected joint measured on a visual analogue scale (0-100 VAS). Secondary outcomes included: time to onset of effect, time to response, time to pain resolution, time to rescue medication use, patient’s and physician’s assessments of global response, clinical signs, inflammatory biomarkers and safety.Methods:Patients were recruited who had acute gout based on ACR/EULAR 2015 gout classification criteria, and were unsuitable for anti-inflammatory therapy with NSAIDs and colchicine due to contraindication, intolerance or inefficacy. Patients were randomized to each group in a 1:1:1 ratio and stratified by urate-lowering therapy use (yes/no) and BMI (<30.0 or ≥30.0 kg/m2).Results:165 patients were randomized; 110 to anakinra (56 to 100 mg/day, 54 to 200 mg/day) and 55 to triamcinolone; 108 and 53 were included in the primary analysis, respectively. The median (range) age was 55 (25-83) years, 87% were male, mean disease duration was 8.7 years and mean number of self-reported flares during the past year was 4.5. The pain intensity, from baseline to 24-72 hours, decreased in both treatment groups; mean (95% CI) change was -39.4 (-46.8, -32.0) for triamcinolone and -41.2 (-46.3, -36.2) for anakinra. The 100 mg and 200 mg doses of anakinra were comparably effective in decreasing pain (100 mg/day: -41.8 [-48.9, -34.8] and 200 mg/day: -40.7 [-47.9, -33.4]). Mean (95% CI) difference in pain reduction between anakinra and triamcinolone treatment groups was -1.8 (-10.8, 7.1) (p-value = 0.688 for primary endpoint). The majority of secondary efficacy endpoints were numerically in favor of anakinra, and in most instances also statistically significant, in comparison to triamcinolone, e.g. physician’s assessment of clinical signs at 72 hours and patient’s and physician’s assessment of global response at Day 8. No unexpected safety findings were identified in any of the treatment groups.Conclusion:Anakinra and triamcinolone reduced patient-assessed gout flare pain to similar degrees in patients for whom conventional therapy was ineffective or contraindicated. Both doses of anakinra showed comparable efficacy in pain reduction. The majority of secondary efficacy endpoints favored anakinra. Anakinra was shown to be an additional option for use during acute gout flares.Disclosure of Interests: :Kenneth Saag Grant/research support from: Horizon, Sobi, Shanton, Grant/research support from: Horizon Pharma, Sobi, Shanton, Consultant of: Horizon and Sobi, Consultant of: Horizon Pharma, Amgen, Radius, LG-Pharma, Takeda, Sobi, Atom, Arthrosi, Alexander So Consultant of: Sobi, Grünenthal, Puja Khanna Grant/research support from: Dyve, Selecta, Sobi, Consultant of: Sobi, Horizon, Robert Keenan Consultant of: Sobi, Selecta, Horizon, Sven Ohlman Shareholder of: Sobi, Employee of: Former employee of Sobi, Torbjörn Kullenberg Shareholder of: Sobi, Employee of: Former employee of Sobi, Lisa Osterling Koskinen Shareholder of: Sobi, Employee of: Sobi, Michael H. Pillinger Grant/research support from: Horizon, Hikma, Consultant of: Sobi, Horizon, Robert Terkeltaub Consultant of: Sobi, Selecta, Horizon, Astra-Zeneca
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Nasi S, Ehirchiou D, Chatzianastasiou A, Nagahara N, Papapetropoulos A, Bertrand J, Cirino G, So A, Busso N. The protective role of the 3-mercaptopyruvate sulfurtransferase (3-MST)-hydrogen sulfide (H 2S) pathway against experimental osteoarthritis. Arthritis Res Ther 2020; 22:49. [PMID: 32183900 PMCID: PMC7077027 DOI: 10.1186/s13075-020-02147-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 03/06/2020] [Indexed: 12/13/2022] Open
Abstract
Background Osteoarthritis (OA) is characterized by the formation and deposition of calcium-containing crystals in joint tissues, but the underlying mechanisms are poorly understood. The gasotransmitter hydrogen sulfide (H2S) has been implicated in mineralization but has never been studied in OA. Here, we investigated the role of the H2S-producing enzyme 3-mercaptopyruvate sulfurtransferase (3-MST) in cartilage calcification and OA development. Methods 3-MST expression was analyzed in cartilage from patients with different OA degrees, and in cartilage stimulated with hydroxyapatite (HA) crystals. The modulation of 3-MST expression in vivo was studied in the meniscectomy (MNX) model of murine OA, by comparing sham-operated to MNX knee cartilage. The role of 3-MST was investigated by quantifying joint calcification and cartilage degradation in WT and 3-MST−/− meniscectomized knees. Chondrocyte mineralization in vitro was measured in WT and 3-MST−/− cells. Finally, the effect of oxidative stress on 3-MST expression and chondrocyte mineralization was investigated. Results 3-MST expression in human cartilage negatively correlated with calcification and OA severity, and diminished upon HA stimulation. In accordance, cartilage from menisectomized OA knees revealed decreased 3-MST if compared to sham-operated healthy knees. Moreover, 3-MST−/− mice showed exacerbated joint calcification and OA severity if compared to WT mice. In vitro, genetic or pharmacologic inhibition of 3-MST in chondrocytes resulted in enhanced mineralization and IL-6 secretion. Finally, oxidative stress decreased 3-MST expression and increased chondrocyte mineralization, maybe via induction of pro-mineralizing genes. Conclusion 3-MST-generated H2S protects against joint calcification and experimental OA. Enhancing H2S production in chondrocytes may represent a potential disease modifier to treat OA.
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Affiliation(s)
- Sonia Nasi
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Driss Ehirchiou
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Athanasia Chatzianastasiou
- First Department of Critical Care and Pulmonary Services, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,Laboratory of Pharmacology, Faculty of Pharmacy, University of Athens, Athens, Greece
| | | | - Andreas Papapetropoulos
- Laboratory of Pharmacology, Faculty of Pharmacy, University of Athens, Athens, Greece.,Center of Clinical, Experimental Surgery & Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Jessica Bertrand
- Department of Orthopaedic Surgery, Otto-von-Guericke University, Magdeburg, Germany
| | - Giuseppe Cirino
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Alexander So
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Nathalie Busso
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
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Wrigley R, Phipps-Green AJ, Topless RK, Major TJ, Cadzow M, Riches P, Tausche AK, Janssen M, Joosten LAB, Jansen TL, So A, Harré Hindmarsh J, Stamp LK, Dalbeth N, Merriman TR. Pleiotropic effect of the ABCG2 gene in gout: involvement in serum urate levels and progression from hyperuricemia to gout. Arthritis Res Ther 2020; 22:45. [PMID: 32164793 PMCID: PMC7069001 DOI: 10.1186/s13075-020-2136-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 02/20/2020] [Indexed: 12/13/2022] Open
Abstract
Background The ABCG2 Q141K (rs2231142) and rs10011796 variants associate with hyperuricaemia (HU). The effect size of ABCG2 rs2231142 on urate is ~ 60% that of SLC2A9, yet the effect size on gout is greater. We tested the hypothesis that ABCG2 plays a role in the progression from HU to gout by testing for association of ABCG2 rs2231142 and rs10011796 with gout using HU controls. Methods We analysed 1699 European gout cases and 14,350 normouricemic (NU) and HU controls, and 912 New Zealand (NZ) Polynesian (divided into Eastern and Western Polynesian) gout cases and 696 controls. Association testing was performed using logistic and linear regression with multivariate adjusting for confounding variables. Results In Europeans and Polynesians, the ABCG2 141K (T) allele was associated with gout using HU controls (OR = 1.85, P = 3.8E− 21 and ORmeta = 1.85, P = 1.3E− 03, respectively). There was evidence for an effect of 141K in determining HU in European (OR = 1.56, P = 1.7E− 18) but not in Polynesian (ORmeta = 1.49, P = 0.057). For SLC2A9 rs11942223, the T allele associated with gout in the presence of HU in European (OR = 1.37, P = 4.7E− 06), however significantly weaker than ABCG2 rs2231142 141K (PHet = 0.0023). In Western Polynesian and European, there was epistatic interaction between ABCG2 rs2231142 and rs10011796. Combining the presence of the 141K allele with the rs10011796 CC-genotype increased gout risk, in the presence of HU, 21.5-fold in Western Polynesian (P = 0.009) and 2.6-fold in European (P = 9.9E− 06). The 141K allele of ABCG2 associated with increased gout flare frequency in Polynesian (Pmeta = 2.5E− 03). Conclusion These data are consistent with a role for ABCG2 141K in gout in the presence of established HU.
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Affiliation(s)
- Rebekah Wrigley
- Department of Biochemistry, University of Otago, Box 56, Dunedin, New Zealand
| | | | - Ruth K Topless
- Department of Biochemistry, University of Otago, Box 56, Dunedin, New Zealand
| | - Tanya J Major
- Department of Biochemistry, University of Otago, Box 56, Dunedin, New Zealand
| | - Murray Cadzow
- Department of Biochemistry, University of Otago, Box 56, Dunedin, New Zealand
| | - Philip Riches
- Rheumatic Diseases Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Anne-Kathrin Tausche
- Department of Rheumatology, University Clinic "Carl-Gustav-Carus", Dresden, Germany
| | - Matthijs Janssen
- Department of Rheumatology, VieCuri Medical Center, Venlo, The Netherlands
| | - Leo A B Joosten
- Department of Internal Medicine and Radboud Institute of Molecular Life Science, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Medical Genetics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Tim L Jansen
- Department of Rheumatology, VieCuri Medical Center, Venlo, The Netherlands
| | - Alexander So
- Laboratory of Rheumatology, University of Lausanne, CHUV, Nestlé 05-5029, 1011, Lausanne, Switzerland
| | | | - Lisa K Stamp
- Department of Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand
| | - Nicola Dalbeth
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Tony R Merriman
- Department of Biochemistry, University of Otago, Box 56, Dunedin, New Zealand.
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Affiliation(s)
- Alexander So
- Service de Rhumatologie, CHUV and University of Lausanne, Lausanne, Switzerland.
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Komada H, Hirota Y, So A, Nakamura T, Okuno Y, Fukuoka H, Iguchi G, Takahashi Y, Sakaguchi K, Ogawa W. Insulin secretion and sensitivity before and after surgical treatment for aldosterone-producing adenoma. Diabetes Metab 2019; 46:236-242. [PMID: 31676325 DOI: 10.1016/j.diabet.2019.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 09/22/2019] [Accepted: 10/14/2019] [Indexed: 11/16/2022]
Abstract
AIM Primary aldosteronism, which is usually caused by an aldosterone-producing tumour, affects glucose metabolism. The effects of this condition on insulin secretion and insulin sensitivity have remained unclear, however. To gain insight into the influence of primary aldosteronism on glucose tolerance, various parameters related to insulin secretion or insulin sensitivity in patients with an aldosterone-producing tumour were comprehensively analyzed. METHODS To assess 14 patients with an aldosterone-producing tumour, hyperglycaemic and hyperinsulinaemic-euglycaemic clamp tests as well as oral glucose tolerance tests (OGTTs) were performed before and after tumour excision. Time between presurgical analysis and surgery was 27-559 (194±132) days, and 14-142 (51±38) days between surgery and postsurgical analysis. Various parameters related to insulin secretion or sensitivity as determined by OGTT as well as hyperglycaemic and hyperinsulinaemic-euglycaemic clamp analyses were evaluated. RESULTS Surgical treatment of tumours ameliorated hypokalaemia and reduced plasma aldosterone levels. First and second phases of insulin secretion during the hyperglycaemic clamp, as well as the insulinogenic index and total insulin secretion measured during OGTT, were also improved after surgery. In addition, the insulin sensitivity index determined during the hyperinsulinaemic-euglycaemic clamp was reduced after surgery. CONCLUSION Primary aldosteronism impairs insulin secretion.
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Affiliation(s)
- H Komada
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Y Hirota
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan.
| | - A So
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - T Nakamura
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Y Okuno
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - H Fukuoka
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - G Iguchi
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Y Takahashi
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - K Sakaguchi
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - W Ogawa
- Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
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Liu L, Garbutt C, Golkaram M, Kaplan S, Martins M, Casino S, Mansinho A, Macedo D, Alvim C, Costa A, Fernandes A, Ferreira C, Aldeia F, Quintela A, Costa L, So A, Zhang S, Pawlowski T. Microsatellite instability testing and lynch syndrome screening for colorectal cancer patients through tumour sequencing. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz257.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Cederberg R, So A, Franks E, Hughes M, Mcnagny K, Bennewith K. P1.04-18 Interleukin-5 Drives the Expansion of Pulmonary B-1 B Cells and Restricts Lung Tumor Growth. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Nappi L, Thi M, Eigl B, Chi K, Gleave M, So A, Black P, Hamilton R, Daneshmand S, Nichols C, Kollmannsberger C. Differential expression of circulating miR375 and miR371 to detect teratoma and viable germ cell malignancy. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Castelblanco M, Nasi S, Pasch A, So A, Busso N. The role of the gasotransmitter hydrogen sulfide in pathological calcification. Br J Pharmacol 2019; 177:778-792. [PMID: 31231793 DOI: 10.1111/bph.14772] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/29/2019] [Accepted: 06/05/2019] [Indexed: 12/11/2022] Open
Abstract
Calcification is the deposition of minerals, mainly hydroxyapatite, inside the cell or in the extracellular matrix. Physiological calcification is central for many aspects of development including skeletal and tooth growth; conversely, pathological mineralization occurs in soft tissues and is significantly associated with malfunction and impairment of the tissue where it is located. Various mechanisms have been proposed to explain calcification. However, this research area lacks a more integrative, systemic, and global perspective that could explain both physiological and pathological processes. In this review, we propose such an integrated explanation. Hydrogen sulfide (H2 S) is a newly recognized multifunctional gasotransmitters and tis actions have been studied in different physiological and pathological contexts, but little is known about its potential role on calcification. Interestingly, we found that H2 S promotes calcification under physiological conditions and has an inhibitory effect on pathological processes. This makes H2 S a potential therapy for diseases related to pathological calcification. LINKED ARTICLES: This article is part of a themed section on Hydrogen Sulfide in Biology & Medicine. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.4/issuetoc.
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Affiliation(s)
- Mariela Castelblanco
- Service of Rheumatology, DAL, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Sonia Nasi
- Service of Rheumatology, DAL, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | | | - Alexander So
- Service of Rheumatology, DAL, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Nathalie Busso
- Service of Rheumatology, DAL, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
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Wong ECL, Breau RH, Mallick R, Wood L, Pouliot F, Basappa NS, Tanguay S, Soulières D, So A, Heng D, Lavallée LT, Drachenberg D, Kapoor A. Renal cell carcinoma in the Canadian Indigenous population. ACTA ACUST UNITED AC 2019; 26:e367-e371. [PMID: 31285681 DOI: 10.3747/co.26.4707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Diagnosis and treatment of renal cell carcinoma (rcc) might be different in Indigenous Canadians than in non-Indigenous Canadians. In this cohort study, we compared rcc presentation and treatments in Indigenous and non-Indigenous Canadians. Methods Patients registered in the Canadian Kidney Cancer Information System treated at 16 institutions between 2011 and 2018 were included. Baseline patient, tumour, and treatment characteristics were compared between Indigenous and non-Indigenous Canadians. The primary objective was to determine if differences in rcc stage at diagnosis were evident between the groups. The secondary objective was to determine if treatments and outcomes were different between the groups. Results During the study period, 105 of the 4529 registered patients self-identified as Indigenous. Those patients were significantly younger at the time of clinical diagnosis (57.9 ± 11.3 years vs. 62.0 ± 12.1 years, p = 0.0006) and had a family history prevalence of rcc that was double the prevalence in the non-Indigenous patients (14% vs. 7%, p = 0.004). Clinical stage at diagnosis was similar in the two groups (p = 0.61). The disease was metastatic at presentation in 11 Indigenous Canadians (10%) and in 355 non-Indigenous Canadians (8%). Comorbid conditions that could affect the management of rcc-such as obesity, renal disease, diabetes mellitus, and smoking-were more common in Indigenous Canadians (p < 0.05). Indigenous Canadians experienced a lower rate of active surveillance (p = 0.01). Treatments and median time to treatments were similar in the two groups. Conclusions Compared with their non-Indigenous counterparts, Indigenous Canadian patients with rcc are diagnosed at an earlier age and at a similar clinical stage. Despite higher baseline comorbid conditions, clinical outcomes are not worse for Indigenous Canadians than for non-Indigenous Canadians.
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Affiliation(s)
- E C L Wong
- Department of Surgery, McMaster University, Hamilton, ON
| | - R H Breau
- Department of Surgery, University of Ottawa, Ottawa, ON
| | - R Mallick
- Ottawa Methods Centre, The Ottawa Hospital Research Institute, Ottawa, ON
| | - L Wood
- Department of Medicine, Dalhousie University, Halifax, NS
| | - F Pouliot
- Department of Surgery, Université Laval, Quebec City, QC
| | - N S Basappa
- Department of Medicine, University of Alberta, Edmonton, AB
| | - S Tanguay
- Department of Surgery, McGill University, Montreal, QC
| | - D Soulières
- Department of Surgery, Université de Montréal, Montreal, QC
| | - A So
- Department of Surgery, University of British Columbia, Vancouver, BC
| | - D Heng
- Department of Medicine, University of Calgary, Calgary, AB
| | - L T Lavallée
- Department of Surgery, University of Ottawa, Ottawa, ON
| | - D Drachenberg
- Department of Surgery, University of Manitoba, Winnipeg, MB
| | - A Kapoor
- Department of Surgery, McMaster University, Hamilton, ON
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Zufferey P, Valcov R, Thomas M, Dumusc A, Forien M, So A, Ottaviani S. Efficacy of anakinra in acute hydroxyapatite calcification-induced joint pain: A retrospective study of 23 cases. Joint Bone Spine 2019; 86:83-88. [DOI: 10.1016/j.jbspin.2018.05.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 05/14/2018] [Indexed: 12/15/2022]
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Nappi L, Thi M, Eigl B, Lum A, Huntsman D, Martin C, Neil B, Khalaf D, Chi K, Gleave M, So A, Black P, Daneshmand S, Nichols C, Kollmannsberger C. Plasma miR-371a-3p for detection of non-teratomatous viable germ cell tumor in testicular cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy283.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
The translation of our knowledge of the biology of MSU crystal-induced IL-1 secretion gives rise to new targets and therapeutic strategies in the treatment of acute gout. The NACHT, LRR and PYD domains-containing protein 3 inflammasome is key to this, and is the subject of intense research. Novel pathways that modulate inflammasome activation, reactive oxygen species generation and extracellular processing of IL-1 have been described and show promise in in vitro and animal studies. Meanwhile, blocking IL-1 by various IL-1 inhibitors has shown the validity of this concept. Patients with acute gout treated with these inhibitors showed positive clinical and biological responses. More work needs to be performed to assess the risk/benefit profile of anti-IL-1 therapies as well as to identify those who will benefit the most from this novel approach to the treatment of gout.
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Affiliation(s)
- Alexander So
- Service de Rhumatologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Alexandre Dumusc
- Service de Rhumatologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Sonia Nasi
- Service de Rhumatologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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Li YR, Steel L, Carrigan E, Nguyen J, Williams A, So A, Mamtani R, Tchou JC. Abstract P3-09-04: Withdrawn. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-09-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- YR Li
- University of Pennsylvania; Perelman School of Medicine, Philadelphia, PA; Eisenhower Medical Center; Internal Medicine Residency Program, Rancho Mirage, CA
| | - L Steel
- University of Pennsylvania; Perelman School of Medicine, Philadelphia, PA; Eisenhower Medical Center; Internal Medicine Residency Program, Rancho Mirage, CA
| | - E Carrigan
- University of Pennsylvania; Perelman School of Medicine, Philadelphia, PA; Eisenhower Medical Center; Internal Medicine Residency Program, Rancho Mirage, CA
| | - J Nguyen
- University of Pennsylvania; Perelman School of Medicine, Philadelphia, PA; Eisenhower Medical Center; Internal Medicine Residency Program, Rancho Mirage, CA
| | - A Williams
- University of Pennsylvania; Perelman School of Medicine, Philadelphia, PA; Eisenhower Medical Center; Internal Medicine Residency Program, Rancho Mirage, CA
| | - A So
- University of Pennsylvania; Perelman School of Medicine, Philadelphia, PA; Eisenhower Medical Center; Internal Medicine Residency Program, Rancho Mirage, CA
| | - R Mamtani
- University of Pennsylvania; Perelman School of Medicine, Philadelphia, PA; Eisenhower Medical Center; Internal Medicine Residency Program, Rancho Mirage, CA
| | - JC Tchou
- University of Pennsylvania; Perelman School of Medicine, Philadelphia, PA; Eisenhower Medical Center; Internal Medicine Residency Program, Rancho Mirage, CA
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Castelblanco M, Lugrin J, Ehirchiou D, Nasi S, Ishii I, So A, Martinon F, Busso N. Hydrogen sulfide inhibits NLRP3 inflammasome activation and reduces cytokine production both in vitro and in a mouse model of inflammation. J Biol Chem 2017; 293:2546-2557. [PMID: 29279328 DOI: 10.1074/jbc.m117.806869] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 11/17/2017] [Indexed: 12/13/2022] Open
Abstract
A variety of stimuli, including monosodium urate (MSU) crystals, activate the NLRP3 inflammasome, and this activation involves several molecular mechanisms including xanthine oxidase (XO) up-regulation and mitochondrial dysfunction. Upon oligomerization of apoptosis-associated speck-like protein containing a CARD (ASC), caspase-1 becomes active and cleaves the proinflammatory cytokine IL-1β into its active secreted form. Hydrogen sulfide (H2S), a gasotransmitter mainly produced by cystathionine γ-lyase (CSE) in macrophages, could modulate inflammation. Here, we sought to investigate the effects of exogenous and endogenous H2S on NLRP3 inflammasome activation in vitro and in vivo Primed bone marrow-derived macrophages (BMDM) isolated from wildtype (wt) or CSE-deficient mice and human macrophages (THP1 cells and primary macrophages), were stimulated with MSU crystals in the presence or absence of a H2S donor, sodium thiosulfate (STS) or GYY4137 (GYY). In murine and human macrophages in vitro, both STS and GYY inhibited MSU crystal-induced IL-1β secretion in a dose-dependent manner. Moreover, the H2S donors inhibited MSU crystal-induced XO/caspase-1 activities, mitochondrial reactive oxygen species (ROS) generation, and ASC oligomerization. Accordingly, IL-1β secretion and XO/caspase-1 activities were higher in CSE-deficient BMDMs than in wt BMDMs. For in vivo studies, we experimentally induced peritonitis by intraperitoneal injection of MSU crystals into mice. GYY pretreatment ameliorated inflammation, evidenced by decreased IL-6/monocyte chemoattractant protein-1 (MCP-1) released into peritoneal lavages. Taken together, our results suggest that both exogenous (via H2S donors) and endogenous (via CSE) H2S production may represent approaches for managing, for example, acute gout or other inflammation conditions.
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Affiliation(s)
| | - Jérôme Lugrin
- the Department of Biochemistry, University of Lausanne, Epalinges 155 1066, Switzerland and
| | - Driss Ehirchiou
- the Department of Biochemistry, University of Lausanne, Epalinges 155 1066, Switzerland and
| | - Sonia Nasi
- From the Service of Rheumatology, DAL, Lausanne University Hospital (CHUV) and
| | - Isao Ishii
- Showa Pharmaceutical University, Tokyo 194-8543, Japan
| | - Alexander So
- From the Service of Rheumatology, DAL, Lausanne University Hospital (CHUV) and
| | - Fabio Martinon
- the Department of Biochemistry, University of Lausanne, Epalinges 155 1066, Switzerland and
| | - Nathalie Busso
- From the Service of Rheumatology, DAL, Lausanne University Hospital (CHUV) and
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Safran A, Perreau M, So A, Zufferey P. High titers of ADAbs in rheumatic disease patients undergoing anti-TNF therapy is not associated with lupus-like autoimmunity. Lupus 2017. [DOI: 10.1177/0961203317713145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- A Safran
- Service of Rheumatology (RHU/DAL), Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - M Perreau
- Service of Immunology and Allergy, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - A So
- Service of Rheumatology (RHU/DAL), Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - P Zufferey
- Service of Rheumatology (RHU/DAL), Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
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Nasi S, Ea HK, So A, Busso N. Revisiting the Role of Interleukin-1 Pathway in Osteoarthritis: Interleukin-1α and -1β, and NLRP3 Inflammasome Are Not Involved in the Pathological Features of the Murine Menisectomy Model of Osteoarthritis. Front Pharmacol 2017; 8:282. [PMID: 28659793 PMCID: PMC5468399 DOI: 10.3389/fphar.2017.00282] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 05/04/2017] [Indexed: 01/10/2023] Open
Abstract
Background: Innate immune response components such as toll-like receptors (TLRs) and NLRP3-inflammasome act in concert to increase IL-1α/β secretion by synovial macrophages. Previous results suggest that IL-1α/β could be an important mediator involved in the pathogenesis of osteoarthritis (OA). Objectives: The aim of our study was to evaluate the role of NLRP3, IL-1β, and IL-1α in the menisectomy (MNX) model of murine OA. Methods: Murine chondrocytes (CHs) and bone marrow-derived machrophages (BMDM) were stimulated with hydroxyapatite (HA) crystals, a form of calcium-containing crystal found in human OA, and IL-1β and IL-6 secretion assayed by ELISA.Conversely, the ability of IL-1β and IL-6 to induce CHs calcification was assessed in vitro by Alizarin red staining. Knees from 8 to 10 weeks old C57Bl/6J wild-type (WT) (n = 7), NLRP3-/- (n = 9), IL-1α-/- (n = 5), and IL-1β-/- (n = 5) mice were menisectomized, using the sham-operated contralateral knee as control. 8 weeks later, knee cartilage degradation and synovial inflammation were evaluated by histology. In addition, apoptotic chondrocytes, metalloproteases activity, and collagen-type 2 expression were evaluated in all mice. Joint calcification and subchondral bone parameters were quantified by CT-scan in WT and IL-1β-/- menisectomized knees. Results:In vitro, HA crystals induced significant increased IL-6 secretion by CHs, while IL-1β remained undetectable.Conversely, both IL-6 and IL-1β were able to increase chondrocytes mineralization. In vivo, operated knees exhibited OA features compared to sham-operated knees as evidenced by increased cartilage degradation and synovial inflammation. In menisectomized KO mice, severity and extent of cartilage lesions were similar (IL-1α-/- mice) or exacerbated (IL-1β-/- and NLRP3-/- mice) compared to that of menisectomized WT mice. Metalloproteases activity, collagen-type 2 expression, chondrocytes apoptosis, and synovial inflammation were similar between KO and WT mice menisectomized knees. Moreover, the extent of joint calcification in osteoarthritic knees was comparable between IL-1β-/- and WT mice. Conclusions: MNX knees recapitulated features of OA, i.e, cartilage destruction, synovial inflammation, cell death, and joint calcification. Deficiency of IL-1α did not impact on the severity of these features, whereas deficiency of IL-1β or of NLRP3 led to increased cartilage erosion. Our results suggest that IL-1α and IL-1β are not key mediators in this murine OA model and may explain the inefficiency of IL-1 targeted therapies in OA.
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Affiliation(s)
- Sonia Nasi
- Département de l'appareil Locomoteur, Service of Rheumatology, Centre Hospitalier Universitaire Vaudois and University of LausanneLausanne, Switzerland
| | - Hang-Korng Ea
- Institut National de la Santé et de la Recherche Médicale, UMR-1132, Hospital LariboisièreParis, France.,Departement de Rhumatologie, Université Paris Diderot (UFR de Médecine)Paris, France
| | - Alexander So
- Département de l'appareil Locomoteur, Service of Rheumatology, Centre Hospitalier Universitaire Vaudois and University of LausanneLausanne, Switzerland
| | - Nathalie Busso
- Département de l'appareil Locomoteur, Service of Rheumatology, Centre Hospitalier Universitaire Vaudois and University of LausanneLausanne, Switzerland
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Zufferey P, Rebell C, Benaim C, Ziswiler HR, Dumusc A, So A. Ultrasound can be useful to predict an evolution towards rheumatoid arthritis in patients with inflammatory polyarthralgia without anticitrullinated antibodies. Joint Bone Spine 2017; 84:299-303. [DOI: 10.1016/j.jbspin.2016.05.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 05/18/2016] [Indexed: 10/21/2022]
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Gabay C, So A. [Not Available]. Rev Med Suisse 2017; 13:539-540. [PMID: 28718585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Cem Gabay
- Service de rhumatologie, HUG, Genève
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Bardin T, Keenan RT, Khanna PP, Kopicko J, Fung M, Bhakta N, Adler S, Storgard C, Baumgartner S, So A. Lesinurad in combination with allopurinol: a randomised, double-blind, placebo-controlled study in patients with gout with inadequate response to standard of care (the multinational CLEAR 2 study). Ann Rheum Dis 2016; 76:811-820. [PMID: 27821644 PMCID: PMC5530336 DOI: 10.1136/annrheumdis-2016-209213] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 08/25/2016] [Accepted: 10/05/2016] [Indexed: 01/19/2023]
Abstract
Objectives Determine the efficacy and safety of daily lesinurad (200 or 400 mg orally) added to allopurinol in patients with serum uric acid (sUA) above target in a 12-month, randomised, phase III trial. Methods Patients on allopurinol ≥300 mg (≥200 mg in moderate renal impairment) had sUA level of ≥6.5 mg/dL (≥387 µmol/L) at screening and two or more gout flares in the prior year. Primary end point was the proportion of patients achieving sUA level of <6.0 mg/dL (<357 µmol/L) (month 6). Key secondary end points were mean gout flare rate requiring treatment (months 7 through 12) and proportions of patients with complete resolution of one or more target tophi (month 12). Safety assessments included adverse events and laboratory data. Results Patients (n=610) were predominantly male, with mean (±SD) age 51.2±10.90 years, gout duration 11.5±9.26 years and baseline sUA of 6.9±1.2 mg/dL (410±71 µmol/L). Lesinurad at 200 and 400 mg doses, added to allopurinol, significantly increased proportions of patients achieving sUA target versus allopurinol-alone therapy by month 6 (55.4%, 66.5% and 23.3%, respectively, p<0.0001 both lesinurad+allopurinol groups). In key secondary end points, there were no statistically significant treatment-group differences favouring lesinurad. Lesinurad was generally well tolerated; the 200 mg dose had a safety profile comparable with allopurinol-alone therapy. Renal-related adverse events occurred in 5.9% of lesinurad 200 mg+allopurinol, 15.0% of lesinurad 400 mg+allopurinol and 4.9% of allopurinol-alone groups, with serum creatinine elevation of ≥1.5× baseline in 5.9%, 15.0% and 3.4%, respectively. Serious treatment-emergent adverse events occurred in 4.4% of lesinurad 200 mg+allopurinol, in 9.5% of lesinurad 400 mg+allopurinol and in 3.9% of allopurinol-alone groups, respectively. Conclusion Lesinurad added to allopurinol demonstrated superior sUA lowering versus allopurinol-alone therapy and lesinurad 200 mg was generally well tolerated in patients with gout warranting additional therapy. Trial registration number NCT01493531.
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Affiliation(s)
- Thomas Bardin
- Rhumatologie, Lariboisière Hospital, and Université Paris Diderot Sorbonne Cité, Paris, France
| | - Robert T Keenan
- Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina, USA
| | - Puja P Khanna
- Division of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jeff Kopicko
- Biometrics, Ardea Biosciences, Inc., San Diego, California, USA
| | - Maple Fung
- Research & Development, Ardea Biosciences, Inc., San Diego, California, USA
| | - Nihar Bhakta
- Research & Development, Ardea Biosciences, Inc., San Diego, California, USA
| | - Scott Adler
- Research & Development, AstraZeneca Pharmaceuticals, Gaithersburg, Maryland, USA
| | - Chris Storgard
- Research & Development, Ardea Biosciences, Inc., San Diego, California, USA
| | - Scott Baumgartner
- Medical Affairs, Ardea Biosciences, Inc., San Diego, California, USA
| | - Alexander So
- Service de rhumatologie, Université de Lausanne, Lausanne, Switzerland
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Kiltz U, Smolen J, Bardin T, Cohen Solal A, Dalbeth N, Doherty M, Engel B, Flader C, Kay J, Matsuoka M, Perez-Ruiz F, da Rocha Castelar-Pinheiro G, Saag K, So A, Vazquez Mellado J, Weisman M, Westhoff TH, Yamanaka H, Braun J. Treat-to-target (T2T) recommendations for gout. Ann Rheum Dis 2016; 76:632-638. [PMID: 27658678 DOI: 10.1136/annrheumdis-2016-209467] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 08/26/2016] [Accepted: 08/27/2016] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The treat-to-target (T2T) concept has been applied successfully in several inflammatory rheumatic diseases. Gout is a chronic disease with a high burden of pain and inflammation. Because the pathogenesis of gout is strongly related to serum urate levels, gout may be an ideal disease in which to apply a T2T approach. Our aim was to develop international T2T recommendations for patients with gout. METHODS A committee of experts with experience in gout agreed upon potential targets and outcomes, which was the basis for the systematic literature search. Eleven rheumatologists, one cardiologist, one nephrologist, one general practitioner and one patient met in October 2015 to develop T2T recommendations based on the available scientific evidence. Levels of evidence, strength of recommendations and levels of agreement were derived. RESULTS Although no randomised trial was identified in which a comparison with standard treatment or an evaluation of a T2T approach had been performed in patients with gout, indirect evidence was provided to focus on targets such as normalisation of serum urate levels. The expert group developed four overarching principles and nine T2T recommendations. They considered dissolution of crystals and prevention of flares to be fundamental; patient education, ensuring adherence to medications and monitoring of serum urate levels were also considered to be of major importance. CONCLUSIONS This is the first application of the T2T approach developed for gout. Since no publication reports a trial comparing treatment strategies for gout, highly credible overarching principles and level D expert recommendations were created and agreed upon.
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Affiliation(s)
- U Kiltz
- Rheumazentrum Ruhrgebiet, and Ruhr University Bochum, Herne, Germany
| | - J Smolen
- Division of Rheumatology, Department of Medicine 3, Medical University of Vienna, Vienna, Austria
| | - T Bardin
- Assisitance Publique Hôpitaux de Paris Rheumatology Department, Lariboisière Hospital, University Paris Diderot, Sorbonne Paris-Cité and INSERM, UMR 1132, Paris, France
| | - A Cohen Solal
- Research Medical Unit INSERM, Université Paris VII-Denis Diderot Assistance Publique-Hôpitaux de Paris, Service de Cardiologie, Hôpital Lariboisière, Paris, France
| | - N Dalbeth
- University of Auckland and Auckland District Health Board, Auckland, New Zealand
| | - M Doherty
- University of Nottingham, Nottingham, UK
| | - B Engel
- Medical Faculty, Institute of General Practice and Family Medicine, University Bonn, Bonn, Germany
| | - C Flader
- Rheumazentrum Ruhrgebiet, and Ruhr University Bochum, Herne, Germany
| | - J Kay
- UMass Memorial Medical Center and University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - M Matsuoka
- Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - F Perez-Ruiz
- Rheumatology Division, Hospital de Cruces, Baracaldo, Vizcaya, Spain
| | | | - K Saag
- University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - A So
- Service de Rhumatologie, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - J Vazquez Mellado
- Servicio de Reumatología, Hospital General de México, México City, México
| | - M Weisman
- Division of Rheumatology, Cedars-Sinai Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, USA
| | - T H Westhoff
- Medical Department I, Marien Hospital Herne, Ruhr-University of Bochum, Herne, Germany
| | - H Yamanaka
- Tokyo Women's Medical University, Tokyo, Japan
| | - J Braun
- Rheumazentrum Ruhrgebiet, and Ruhr University Bochum, Herne, Germany
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Abstract
In this article, the authors consider the manifestations of intraarticular and periarticular crystal deposits. Most cases of crystal deposits are asymptomatic and represent incidental findings at imaging. In symptomatic arthropathies, imaging can play an important role in the diagnosis and assessment of disease progression and the extent of crystal deposits. Conventional radiography is the most common imaging modality. But ultrasound, conventional computerized tomography (CT), dual-energy CT, and MRI play an increasing role. The authors review typical radiographic features of crystal-induced arthropathies and findings that help to differentiate them. The authors also emphasize the increasing role of complementary imaging techniques.
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Affiliation(s)
- Patrick Omoumi
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Rue du Bugnon 46, Lausanne 1011, Switzerland.
| | - Pascal Zufferey
- Department of Rheumatology, Lausanne University Hospital, Av Pierre Decker 5, Lausanne 1011, Switzerland
| | - Jacques Malghem
- Department of Radiology, Saint Luc University Hospital, UC Louvain, Av Hippocrate 10, Brussels 1200, Belgium
| | - Alexander So
- Department of Rheumatology, Lausanne University Hospital, Av Pierre Decker 5, Lausanne 1011, Switzerland
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Wüthrich H, Alromaih F, So A. Guidelines for the treatment of gout: a Swiss perspective. Swiss Med Wkly 2016; 146:w14341. [PMID: 27585109 DOI: 10.4414/smw.2016.14341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Gout is a common condition and its management is suboptimal. A number of guidelines on the management of gout have been published in the last decade by professional societies with the aim of informing the physician of the recommended therapeutic strategies and the treatment options. We have tried to synthesize the current recommendations and to highlight some challenges that still need to be resolved in clinical practice in Switzerland.
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Affiliation(s)
| | | | - Alexander So
- Service de Rhumatologie, CHUV, Lausanne, Switzerland
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Richette P, Doherty M, Pascual E, Barskova V, Becce F, Castañeda-Sanabria J, Coyfish M, Guillo S, Jansen TL, Janssens H, Lioté F, Mallen C, Nuki G, Perez-Ruiz F, Pimentao J, Punzi L, Pywell T, So A, Tausche AK, Uhlig T, Zavada J, Zhang W, Tubach F, Bardin T. 2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis 2016; 76:29-42. [DOI: 10.1136/annrheumdis-2016-209707] [Citation(s) in RCA: 817] [Impact Index Per Article: 102.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 06/14/2016] [Accepted: 06/29/2016] [Indexed: 12/22/2022]
Abstract
BackgroundNew drugs and new evidence concerning the use of established treatments have become available since the publication of the first European League Against Rheumatism (EULAR) recommendations for the management of gout, in 2006. This situation has prompted a systematic review and update of the 2006 recommendations.MethodsThe EULAR task force consisted of 15 rheumatologists, 1 radiologist, 2 general practitioners, 1 research fellow, 2 patients and 3 experts in epidemiology/methodology from 12 European countries. A systematic review of the literature concerning all aspects of gout treatments was performed. Subsequently, recommendations were formulated by use of a Delphi consensus approach.ResultsThree overarching principles and 11 key recommendations were generated. For the treatment of flare, colchicine, non-steroidal anti-inflammatory drugs (NSAIDs), oral or intra-articular steroids or a combination are recommended. In patients with frequent flare and contraindications to colchicine, NSAIDs and corticosteroids, an interleukin-1 blocker should be considered. In addition to education and a non-pharmacological management approach, urate-lowering therapy (ULT) should be considered from the first presentation of the disease, and serum uric acid (SUA) levels should be maintained at<6 mg/dL (360 µmol/L) and <5 mg/dL (300 µmol/L) in those with severe gout. Allopurinol is recommended as first-line ULT and its dosage should be adjusted according to renal function. If the SUA target cannot be achieved with allopurinol, then febuxostat, a uricosuric or combining a xanthine oxidase inhibitor with a uricosuric should be considered. For patients with refractory gout, pegloticase is recommended.ConclusionsThese recommendations aim to inform physicians and patients about the non-pharmacological and pharmacological treatments for gout and to provide the best strategies to achieve the predefined urate target to cure the disease.
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Nasi S, Ea HK, Lioté F, So A, Busso N. Sodium Thiosulfate Prevents Chondrocyte Mineralization and Reduces the Severity of Murine Osteoarthritis. PLoS One 2016; 11:e0158196. [PMID: 27391970 PMCID: PMC4938519 DOI: 10.1371/journal.pone.0158196] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 06/13/2016] [Indexed: 12/02/2022] Open
Abstract
Objectives Calcium-containing crystals participate in the pathogenesis of OA. Sodium thiosulfate (STS) has been shown to be an effective treatment in calcification disorders such as calciphylaxis and vascular calcification. This study investigated the effects and mechanisms of action of STS in a murine model of OA and in chondrocyte calcification. Methods Hydroxyapatite (HA) crystals-stimulated murine chondrocytes and macrophages were treated with STS. Mineralization and cellular production of IL-6, MCP-1 and reactive oxygen species (ROS) were assayed. STS's effects on genes involved in calcification, inflammation and cartilage matrix degradation were studied by RT-PCR. STS was administered in the menisectomy model of murine OA, and the effect on periarticular calcific deposits and cartilage degeneration was investigated by micro-CT-scan and histology. Results In vitro, STS prevented in a dose-dependent manner calcium crystal deposition in chondrocytes and inhibited Annexin V gene expression. In addition, there was a reduction in crystal-induced IL-6 and MCP-1 production. STS also had an antioxidant effect, diminished HA-induced ROS generation and abrogated HA-induced catabolic responses in chondrocytes. In vivo, administration of STS reduced the histological severity of OA, by limiting the size of new periarticular calcific deposits and reducing the severity of cartilage damage. Conclusions STS reduces the severity of periarticular calcification and cartilage damage in an animal model of OA via its effects on chondrocyte mineralization and its attenuation of crystal-induced inflammation as well as catabolic enzymes and ROS generation. Our study suggests that STS may be a disease-modifying drug in crystal-associated OA.
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Affiliation(s)
- Sonia Nasi
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
- * E-mail:
| | - Hang-Korng Ea
- Hospital Lariboisière, Service of Rheumatology, University School of Medicine, Paris VII, Paris, France
| | - Frédéric Lioté
- Hospital Lariboisière, Service of Rheumatology, University School of Medicine, Paris VII, Paris, France
| | - Alexander So
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | - Nathalie Busso
- Service of Rheumatology, Department of Musculoskeletal Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
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